Search results for: safe motherhood program India

Authors: Joana PaScoa Pinheiro, David Goncalves Ferreira, Filipe Ramos, Joaquim Soares Do Brito, Samuel Martins, Marco Sarmento

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Introduction: The SARS-CoV-2 (COVID-19) pandemic was identified in January 2020 in China, in the city of Wuhan. The increase in the number of cases over the following months was responsible for the restructuring of hospitals and departments in order to accommodate admissions related to COVID-19. Essential services, such as trauma, had to readapt to maintain their functionality and thus guarantee quick and safe access in case of an emergency. Objectives: This study describes the impact of COVID-19 on a Level III Trauma Center and particularly on the clinical management of hospitalized patients with spine injuries. Study Design & Methods: This is a retrospective cohort study whose results were obtained through the medical records of patients with spine injuries who underwent surgical intervention in the years 2019 and 2020 (period from March 1st to December 31st). A comparison between the two groups was made. In the study patients with injuries in the context of trauma were included who underwent surgery in the periods previously described. Patients hospitalized with a spine injury in a non-traumatic context and/or were not surgically treated were excluded. Results: In total, 137 patients underwent trauma spine surgery of which 71 in 2019 (51.8%) were without significant differences in intergroup comparisons. The most frequent injury mechanism in 2019 was motor vehicle crash (47.9%) compared to 2020 which was of a person falling from a height between 2-4 meters (37.9%). Cervical trauma was reported to be the most frequent spine injury in both years. There was a significant decrease in the need for intensive care in 2020, 51.4% vs 30.3%, p = .015 and the number of complications was also lower in 2020 (1.35% vs 0.98%), including the number of deaths, being the difference marginally significant. There were no significant differences regarding time for presentation to surgery or in the total days of hospitalization. Conclusions: The restructuring made in the trauma unit at a Level III Trauma Center in the context of the current COVID-19 pandemic was effective, with no significant differences between the years of 2019 vs 2020 when compared with the time for presentation to surgery or the number of days of hospitalization. It was also found that lockdown rules in 2020 were probably responsible for the decrease in the number of road traffic accidents, which justifies a significant decrease in the need for intensive care as well as in the number of complications in patients hospitalized in the context of spine trauma.

Keywords: trauma, spine, impact, covid-19

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Authors: Erika Duggan

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A Major Hospital had identified that there was no standard process for handling a patient’s medication that they brought with them to the hospital. It was also identified that each floor was handling the patient’s medication differently and storing it in multiple locations. Based on this disconnect many patients were leaving the hospital without their medication. The project team was tasked with creating a cohesive process to send a patient’s unneeded medication home on admission, storing any of the patient’s medication that could not be sent home, storing any of the patient’s medication for inpatient administration, and sending all of the patient’s medication home on discharge. The project team consisted of pharmacists, RNs, LPNs, members from nursing informatics and a project engineer and followed a DMAIC framework. Working together observations were performed to identify what was working and not working on the different floors which resulted in process maps. Using the multidisciplinary team, brainstorming, including affinity diagramming and other lean six sigma techniques, the best process for receiving, storing, and returning the medication was created. It was highlighted that being able to track the medication throughout the patient’s stay would be beneficial and would help make sure the medication left with the patient on discharge. Using an automated medications dispensing system would help store, and track patient’s medications. Also, the use of a specific order that would show up on the discharge instructions would assist the front line staff in retrieving the medication from a set location and sending it home with the patient. This new process will effectively streamline the admission and discharge process for patients who brought their medication with them as well as effectively tracking the medication during the patient’s stay. As well as increasing patient safety as it relates to medication administration.

Keywords: lean six sigma, medication dispensing, process improvement, process mapping

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Authors: Sharat Chandra, Zilong Wang, Ru-Rong Ji, Andrey Bortsov

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Chronic pain (CP) therapeutic approaches have limited efficacy. As a result, doctors are prescribing opioids for chronic pain, leading to opioid overuse, abuse, and addiction epidemic. Therefore, the development of effective and safe CP drugs remains an unmet medical need. Voltage-gated sodium (Nav) channels act as cardiovascular and neurological disorder’s molecular targets. Nav channels selective inhibitors are hard to design because there are nine closely-related isoforms (Nav1.1-1.9) that share the protein sequence segments. We are targeting the Nav1.7 found in the peripheral nervous system and engaged in the perception of pain. The objective of this project was to screen a 1.5 million compound library for identification of inhibitors for Nav1.7 with analgesic effect. In this study, we designed a protocol for identification of isoform-selective inhibitors of Nav1.7, by utilizing the prior information on isoform-selective antagonists. First, a similarity search was performed; then the identified hits were docked into a binding site on the fourth voltage-sensor domain (VSD4) of Nav1.7. We used the FTrees tool for similarity searching and library generation; the generated library was docked in the VSD4 domain binding site using FlexX and compounds were shortlisted using a FlexX score and SeeSAR hyde scoring. Finally, the top 25 compounds were tested with molecular dynamics simulation (MDS). We reduced our list to 9 compounds based on the MDS root mean square deviation plot and obtained them from a vendor for in vitro and in vivo validation. Whole-cell patch-clamp recordings in HEK-293 cells and dorsal root ganglion neurons were conducted. We used patch pipettes to record transient Na⁺ currents. One of the compounds reduced the peak sodium currents in Nav1.7-HEK-293 stable cell line in a dose-dependent manner, with IC50 values at 0.74 µM. In summary, our computer-aided analgesic discovery approach allowed us to develop pre-clinical analgesic candidate with significant reduction of time and cost.

Keywords: chronic pain, voltage-gated sodium channel, isoform-selective antagonist, similarity search, virtual screening, analgesics development

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Authors: Rajiv Ratan Singh, Sachin Kumar Tripathi, Pradeep Kumar Yadav

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The timely evaluation, diagnosis, and treatment of people who have been exposed to toxic chemicals is a crucial component of emergency poison management in the medical field. The various substances that can poison include chemicals, medications, and naturally occurring poisons. The toxicology of the particular drug involved, as well as the symptoms and indicators of poisoning, must be thoroughly understood to handle poisoning emergencies effectively. One of the most important aspects of emergency poison management in medicine is the prompt examination, diagnosis, and treatment of persons who have been exposed to dangerous substances. To properly manage poisoning crises, one must have a good understanding of the toxicology of the particular medication concerned, as well as the signs and indicators of poisoning. Emergency management of poisoning includes not only prompt medical attention but also patient education, follow-up care, and monitoring for any long-term consequences. To achieve the greatest results for patients, the management of poisoning is a complicated and dynamic process that calls for collaboration between medical professionals, first responders, and toxicologists. All poisoned patients who present to the emergency room are assessed and diagnosed based on a collection of symptoms and a biochemical diagnosis, and they are then provided targeted, specialized treatment for the toxin identified. This article focuses on the loxodromic strategy as the primary method of treatment for poisoned patients. The authors of this article conclude that mortality and morbidity can be reduced if patients visit the emergency room promptly and receive targeted treatment.

Keywords: antidotes, blood poisoning, emergency medicine, gastric lavage, medico-legal aspects, patient care

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Authors: Fourar Ali, Fourar Fatima Zohra

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Knowledge of sediment characteristics is fundamental to understanding their sedimentary functioning: sedimentation, settlement, and erosion processes of cohesive sediments are controlled by complex interactions between physical, chemical, and biological factors. Sediment transport is of primary importance in river hydraulics and river engineering. Indeed, the displacement of sediments can lead to lasting modifications of the bed in terms of its elevation, slope and roughness. The protection of a bank, for example, is likely to initiate a local incision of the river bed, which, in turn, can lead to the subsidence of the bank. The flows in the natural environment occur in general with heterogeneous boundary conditions because of the distribution of the roughnesses of the fixed or mobile bottoms and of the important deformations of the free surface, especially for the flows with a weak draft considering the irregularity of the bottom. Bedforms significantly influence flow resistance. The arrangement of particles lining the bottom of the stream bed or experimental channel generates waveforms of different sizes that lead to changes in roughness and consequently spatial variability in the turbulent characteristics of the flow. The study which is focused on the laws of friction in alluvial beds, aims to analyze the characteristics of flows and materials constituting the natural channels. Experimental results were obtained by simulating these flows on a rough bottom in an experimental channel at the Hydraulics Laboratory of the University of Batna 2. The system of equations governing the problem is solved using the program named: CLIPPER.5 and ACP.

Keywords: free surface flow, heterogeneous sand, moving bottom bed, friction coefficient, bottom roughness

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Authors: Arpit K. Shrivastava, Nirmal K. Mohakud, Subrat Kumar, Priyadarshi S. Sahu

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Acute diarrhea is one of the major causes of morbidity and mortality among children less than five years of age. Multiple etiologies have been implicated for infectious gastroenteritis causing acute diarrhea. In our study fecal samples (n=165) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies such as Rotavirus, Adenovirus, Diarrhoeagenic Escherichia coli (EPEC, EHEC, STEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. The overall results from our study showed that 57% of children below 5 years of age with acute diarrhea were positive for at least one infectious etiology. Diarrhoeagenic Escherichia coli was detected to be the major etiological agent (29.09%) followed by Rotavirus (24.24%), Shigella (21.21%), Adenovirus (5.45%), Cryptosporidium (2.42%), and Giardia (0.60%). Among the different DEC strains, EPEC was detected significantly higher in <2 years children in comparison to >2 years age group (p =0.001). Concurrent infections with two or more pathogens were observed in 47 of 160 (28.48%) cases with a predominant incidence particularly in <2-year-old children (66.66%) compared to children of 2 to 5 years age group. Co-infection of Rotavirus with Shigella was the most frequent combination, which was detected in 17.94% cases, followed by Rotavirus with EPEC (15.38%) and Shigella with STEC (12.82%). Detection of multiple infectious etiologies and diagnosis of the right causative agent(s) can immensely help in better management of acute childhood diarrhea. In future more studies focusing on the detection of cases with concurrent infections must be carried out, as we believe that the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea.

Keywords: children, co-infection, infectious diarrhea, Odisha

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Authors: Elaine Wong Yee-Sing

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Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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Authors: Jonix Owino, Heather Fuller

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Refugees flee from their home countries due to civil unrest, war, persecution and migrate to Western countries such as the United States in search of a safe haven. Transitioning into a new society and culture can be challenging, thereby affecting refugee’s quality of life and well-being in the host communities. Moreover, as individuals age, they experience physical, cognitive and socioemotional changes that may impact their quality of life. However, little is known about the predictors of quality of life among aging refugees. It is not clear how quality of life varies by age, that is, between midlife refugees in comparison to their older counterparts. In addition to age, other sociodemographic factors such as gender, socioeconomic status, or country of origin are likely to have differential associations to quality of life, yet research on such variations among older refugees is sparse. Thus the present study seeks to explore factors associated with quality of life by asking the following research questions: 1) Do sociodemographic factors (such as age and gender) predict quality of life among older refugees, 2) Is there an association between social integration and quality of life, and 3) Is there an association between migratory related experiences (such as post migratory adjustments) and quality of life. The present study recruited 90 refugees (primarily originating from Bhutan, Somalia, Burundi, and Sudan) aged 50 or older living in the US. The participants completed a structured questionnaire which assessed factors such as participant’s sociodemographic attributes (e.g., age, gender, length of residence in the US, country of origin, employment, level of education, and marital status), and validated measures of social integration, post-migration living difficulties, and quality of life. Preliminary results suggest sociodemographic variability in quality of life among these refugees. Further analyses will be conducted using hierarchical regression analyses to address the following hypotheses: first, it is hypothesized that quality of life will vary by age and gender such that younger refugees and men will report higher quality of life. Second, it is expected that refugees with greater levels of social integration will also report better quality of life. Finally, post-migration factors such as language barriers and family stress are hypothesized to predict poorer quality of life. Further results will be analyzed, including potential moderating effects of age and gender, and resulting findings will be interpreted and discussed. The findings from this study have potential implications for communities on how they can better support older refugees as well as develop social programs that can effectively cater to their well-being. Conclusions will be drawn and discussed in light of policies related to both aging and refugee migration within the context of the US.

Keywords: aging out of place, migration, older refugees, quality of life, social integration

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Authors: Chiao-Wen Lan, David Gere

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Background and Significance: Performance has a rich history of imparting information and encouraging reflection, yet there is a paucity of literature on applying performance as a method of analysis and not as a medium for health education. This study aimed to apply ethnodrama strategies to the issue of HIV-related stigma in rural China and to use a critical performance as a vehicle for communication of health research. Methods: The program, titled 'STOP STIGMA,' included dance, narratives and original quotes from people living with HIV/AIDS in China, and spectacle such as photographs, set, and props corresponding to the history of HIV in rural China. Results: The performance represented a step away from a completely textual interpretation of data towards a theatrical style that begins to privilege what arts-based research scholars Rossiter and colleagues have termed 'an embodied, theatrical representation of data.' It offered an opportunity to deliver individual and collective stories that represent how HIV-positive people experience living with HIV/AIDS in China, which could play an integral part in the formulation of actions to effect change. Discussion: This method of communicating health research has implications for fostering dialogue among researchers, community members, and medical practitioners. Although arts-based approaches are not new to the scientific community, the integration of dance, video, ethnodrama, and sciences provides opportunities to innovate in non-traditional research dissemination and communication.

Keywords: health communication, HIV/AIDS, stigma, vulnerable populations

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Authors: R. F. Vieira, S. A. Figueiredo, O. M. Freitas, V. F. Domingues, C. Delerue-Matos

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The presence of sulphur compounds like hydrogen sulphide and mercaptans is one of the reasons for waste-water treatment and waste management being associated with odour emissions. In this context having a quantifying method for these compounds helps in the optimization of treatment with the goal of their elimination, namely biofiltration processes. The aim of this study was the development of a method for quantification of odorous gases in waste treatment plants air samples. A method based on head space solid phase microextraction (HS-SPME) coupled with gas chromatography - flame photometric detector (GC-FPD) was used to analyse H2S and Metil Mercaptan (MM). The extraction was carried out with a 75-μm Carboxen-polydimethylsiloxane fiber coating at 22 ºC for 20 min, and analysed by a GC 2010 Plus A from Shimadzu with a sulphur filter detector: splitless mode (0.3 min), the column temperature program was from 60 ºC, increased by 15 ºC/min to 100 ºC (2 min). The injector temperature was held at 250 ºC, and the detector at 260 ºC. For calibration curve a gas diluter equipment (digital Hovagas G2 - Multi Component Gas Mixer) was used to do the standards. This unit had two input connections, one for a stream of the dilute gas and another for a stream of nitrogen and an output connected to a glass bulb. A 40 ppm H2S and a 50 ppm MM cylinders were used. The equipment was programmed to the selected concentration, and it automatically carried out the dilution to the glass bulb. The mixture was left flowing through the glass bulb for 5 min and then the extremities were closed. This method allowed the calibration between 1-20 ppm for H2S and 0.02-0.1 ppm and 1-3.5 ppm for MM. Several quantifications of air samples from inlet and outlet of a biofilter operating in a waste management facility in the north of Portugal allowed the evaluation the biofilters performance.

Keywords: biofiltration, hydrogen sulphide, mercaptans, quantification

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Authors: James Ponniah

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Christianity is the largest religious tradition of the world. What makes Christianity a world religion is its characteristics of universality and particularity. Its universality and particularity are closely interrelated. Its university is realized and embodied in its particularities and its particularity is recognized and legitimized through its universality. This paper focuses on the dimension of the particularity of Christianity in that it looks at the particularized ideas and discourses of Christian thinking in India in the 20th century and pays attention to the differing shifts and new shades of meaning in Indian Christian notion of God. Drawing upon the writings of select Indian theologians such as Brahmabandhab Upadhyaya, Sundar Sing, A.J Appasamy, Raymond Panikkar, Amalorpavadass and George Soares Prabhhu, this paper delves into how the contexts—be it personal, political, historical or ecclesial—bear upon the way Indian theologians have conceived and constructed the notion of God in their work. Focusing upon how they responded to the signs of their time through their theological narratives, the paper argues that the religion of Christianity can sustain its universality only when it translates its key notions such as God into indigenous categories and local idioms and thus makes itself relevant to the people among whom it is spread. Monotheistic God of Christianity has to accommodate plurality of expressions if Christian idea God has to capture and convey everyone’s experience of God. The case of Indian Christianity then reveals that a monolithic world religion will be experienced and recognised as truly universal only when it sheds its homogeneity and assumes a heterogeneous portrait through the acquisition of local idioms. Allowing culturally diverse idioms to influence theological categories is not inconsequential to—‘accommodating differences and accepting diversities,’ an issue we encounter within and beyond religious domains in our contemporary times.

Keywords: concept of God, heterogeneity, Indian Christianity, indigenous categories

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Authors: Imran Altaf Wasil, Dinesh Ganvir

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Due to a scarcity of virgin aggregates, the use of reclaimed asphalt pavement (RAP) as a substitute for natural aggregates has gained popularity. Despite the fact that RAP is recycled in asphalt pavement, there is still excess RAP, and its use in concrete pavements has expanded in recent years. According to a survey, 98 percent of India's pavements are flexible. As a result, the maintenance and reconstruction of such pavements generate RAP, which can be reused in concrete pavements as well as surface course, base course, and sub-base of flexible pavements. Various studies on the properties of reclaimed asphalt pavement and its optimal requirements for usage in concrete has been conducted throughout the years. In this study a total of four different mixes were prepared by partially replacing natural aggregates by RAP in different proportions. It was found that with the increase in the replacement level of Natural aggregates by RAP the mechanical and durability properties got reduced. In order to increase the mechanical strength of mixes 40% Glass Granulated Blast Furnace Slag (GGBS) was used and it was found that with replacement of cement by 40% of GGBS, there was an enhancement in the mechanical and durability properties of RAP inclusive PQC mixes. The reason behind the improvement in the properties is due to the processing technique used in order to remove the contaminant layers present in the coarse RAP aggregates. The replacement level of Natural aggregate with RAP was done in proportions of 20%, 40% and 60% along with the partial replacement of cement by 40% GGBS. It was found that all the mixes surpassed the design target value of 40 MPa in compression and 4.5 MPa in flexure making it much more economical and feasible.

Keywords: reclaimed asphalt pavement, pavement quality concrete, glass granulated blast furnace slag, mechanical and durability properties

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Authors: Jin Boo Jeong

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In this study, we elucidated anti-cancer activity and potential molecular mechanism of DKC against human colorectal cancer cells. DKC-E70 suppressed the proliferation of human colorectal cancer cell lines such as HCT116, SW480, LoVo and HT-29. Although DKC-E70 decreased cyclin D1 expression in protein and mRNA level, decreased level of cyclin D1 protein by DKC-E70 occurred at the earlier time than that of cyclin D1 mRNA, which indicates that DKC-E70-mediated downregulation of cyclin D1 protein may be a consequence of the induction of degradation and transcriptional inhibition of cyclin D1. In cyclin D1 degradation, we found that cyclin D1 downregulation by DKC-E70 was attenuated in presence of MG132. In addition, DKC-E70 phosphorylated threonine-286 (T286) of cyclin D1 and T286A abolished cyclin D1 downregulation by DKC-E70. We also observed that DKC-E70-mediated T286 phosphorylation and subsequent cyclin D1 degradation was blocked in presence of the inhibitors of ERK1/2, p38 or GSK3β. In cyclin D1 transcriptional inhibition, DKC-E70 inhibited the expression of β-catenin and TCF4, and β–catenin/TCF-dependent luciferase activity. Our results suggest that DKC-E70 may downregulate cyclin D1 as one of the potential anti-cancer targets through cyclin D1 degradation by T286 phosphorylation dependent on ERK1/2, p38 or GSK3β, and cyclin D1 transcriptional inhibition through Wnt signaling. From these findings, DKC-E70 has potential to be a candidate for the development of chemoprevention or therapeutic agents for human colorectal cancer. This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2016R1D1A3B03931713).

Keywords: anticancer, calyx of persimmon, cyclin D1, Diospyros kaki Thunb., human colorectal cancer

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Authors: Sandeep J. Kumar

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Urbanisation is considered as the primary driver of land use and land cover change that has direct link to population and economic growth. In India, as well as in other developing countries, cities are urbanizing at an alarming rate. This unprecedented and uncontrolled urbanisation can result in urban sprawl. Due to a number of factors, urban sprawl is recognised to be a result of poor planning, inadequate policies, and poor governance. Urban sprawl may be seen as posing a threat to the development of sustainable cities. Hence, it is very essential to manage this. Planning for predicted future growth is critical to avoid the negative effects of urban growth at the local and regional levels. Thiruvananthapuram being the capital city of Kerala is a city of economic success, challenges, and opportunities. Urbanization trends in the city have paved way for Urban Sprawl. This thesis aims to formulate a framework to combat the emerging urban sprawl in the city of Thiruvananthapuram. For that, the first step was to quantify trends of urban growth in Thiruvananthapuram city using Geographical Information System(GIS) and remote sensing techniques. The technique and results obtained in the study are extremely valuable in analysing the land use changes. Secondly, these change in the trends were analysed through some of the critical factors that helped the study to understand the underlying issues of the existing city structure that has resulted in urban sprawl. Anticipating development trends can modify the current order. This can be productively resolved using regional and municipal planning and management strategies. Hence efficient strategies to curb the sprawl in Thiruvananthapuram city have been formulated in this study that can be considered as recommendations for future planning.

Keywords: urbanisation, urban sprawl, geographical information system(GIS), thiruvananthapuram

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Authors: Sushil Kumar Singh, Kumar Rahul, Vivek Tewarson, Sarvesh Kumar, Shobhit Kumar

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Objective: Rheumatic mitral stenosis continues to be a major public health problem in developing countries. When the left atrium (LA) is unable to fill the left ventricle (LV) at normal LA pressures due to impaired relaxation and impaired compliance, diastolic dysfunction occurs. The assessment of left ventricular (LV) diastolic function and filling pressures is of clinical importance to identify underlying cardiac disease, its treatment, and to assess prognosis. 2D echocardiography can detect diastolic dysfunction with excellent sensitivity and minimal risk when compared to the gold standard of invasive pressure-volume measurements. Material and Method: This was a one-year study consisting of twenty-nine patients of isolated rheumatic severe mitral stenosis. Data was analyzed preoperative and post operative (at one month follow-up). Transthoracic 2D echocardiographic parameters of the diastolic function are transmitral flow, pulmonary venous flow, mitral annular tissue doppler, and color M-mode doppler. In our study, mitral valve orifice area, ejection fraction, deceleration time, E/A-wave, E/E’-wave, myocardial performance index of left ventricle (Tei index ), and Mitral inflow propagation velocity were included for echocardiographic evaluation. The statistical analysis was performed on SPSS Version 15.0 statistical analysis software. Result: Twenty-nine patients underwent successful closed mitral commissurotomy for isolated mitral stenosis. The outcome measures were observed pre-operatively and at one-month follow-up. The majority of patients were in NYHA grade III (69.0%) in the preoperative period, which improved to NYHA grade I (48.3%) after closed mitral commissurotomy. Post-surgery mitral valve area increased from 0.77 ± 0.13 to 2.32 ± 0.26 cm, ejection fraction increased from 61.38 ± 4.61 to 64.79 ± 3.22. There was a decrease in deceleration time from 231.55 ± 49.31 to 168.28 ± 14.30 ms, E/A ratio from 1.70 ± 0.54 from 0.89 ± 0.39, E/E’ ratio from 14.59 ± 3.34 to 8.86 ± 3.03. In addition, there was improvement in TIE index from 0.50 ± 0.03 to 0.39 ± 0.06 and mitral inflow propagation velocity from 47.28 ± 3.71 to 57.86 ± 3.19 cm/sec. In peri-operative and follow-up, there was no incidence of severe mitral regurgitation (MR). There was no thromboembolic incident and no mortality.

Keywords: closed mitral valvotomy, mitral stenosis, open mitral commissurotomy, balloon mitral valvotomy

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Authors: Bashir Ahmad Amiri, Nsenda Lukumwena

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The global trend indicates that more and more people live and will continue to live in urban areas. Today cities are expanding both in physical size and number due to the rapid population growth along with sprawl development, which caused the cities to expand beyond the growth boundary and exerting intense pressure on environmental resources specially farmlands to accommodate new housing and urban facilities. Also noticeable is the increase in urban decay along with the increase of slum dwellers present another challenge that most cities in developed and developing countries have to deal with. Today urban practitioners, researchers, planners, and decision-makers are seeking for alternative development and growth management policies to house the rising urban population and also cure the urban decay and slum issues turn to Smart Growth to achieve their goals. Many cities across the globe have adopted smart growth as an alternative growth management tool to deal with patterns and forms of development and to cure the rising urban and environmental problems. The method used in this study is a literature analysis method through reviewing various resources to highlight the potential benefits of Smart Growth in both developed and developing countries and analyze, to what extent it can be a strategic alternative for Afghanistan’s cities, especially the capital city. Hence a comparative analysis is carried on three countries, namely the USA, China, and India to identify the potential benefits of smart growth likely to serve as an achievable broad base for recommendations in different urban contexts.

Keywords: growth management, housing, Kabul city, smart growth, urban-expansion

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Authors: A. Bilek, M. Beldi, T. Cherfi, S. Djebali, S. Larbi

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Finite elements analysis and photoelasticity are used to determine the stress field developed in a double edge notched specimen loaded in tension. The specimen is cut in a birefringent plate. Experimental isochromatic fringes are obtained with circularly polarized light on the analyzer of a regular polariscope. The fringes represent the loci of points of equal maximum shear stress. In order to obtain the stress values corresponding to the fringe orders recorded in the notched specimen, particularly in the neighborhood of the notches, a calibrating disc made of the same material is loaded in compression along its diameter in order to determine the photoelastic fringe value. This fringe value is also used in the finite elements solution in order to obtain the simulated photoelastic fringes, the isochromatics as well as the isoclinics. A color scale is used by the software to represent the simulated fringes on the whole model. The stress concentration factor can be readily obtained at the notches. Good agreements are obtained between the experimental and the simulated fringe patterns and between the graphs of the shear stress particularly in the neighborhood of the notches. The purpose in this paper is to show that one can obtain rapidly and accurately, by the finite element analysis, the isochromatic and the isoclinic fringe patterns in a stressed model as the experimental procedure can be time consuming. Stress fields can therefore be analyzed in three dimensional models as long as the meshing and the limit conditions are properly set in the program.

Keywords: isochromatic fringe, isoclinic fringe, photoelasticity, stress concentration factor

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Authors: Ivelise M. Strozberg, Juliana Sales Frota, Lucas de Oliveira Vale

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The state of Ceara, located in the northeast region of Brazil, is abundant in lateritic soil which has been usually discarded due to its lack of agricultural potential while materials of similar nature have been used as constituents of housing constructive elements in many parts of the world, such as India and Portugal, for decades. Since many of the semi-arid housing conditions in the state of Ceara fail to meet the minimum criteria regarding comfort and safety requirements, this research proposed to study the Ceara lateritic soil and the possibility of its use as a sustainable building block constituent for social housings, collaborating to the improvement of the region living conditions. In order to achieve this objective, soil samples were collected from five different locations within the specific region, three of which presented lateritic nature, being characterized according to the Unified Soil Classification System and the MCT methodology, which is a Brazilian methodology developed during the 80’s that aimed to better describe and approach tropical soils, its characterization and behavior. Two of these samples were used to build two different miniature block prototypes, which were manually molded, heated at low temperatures -( < 300 ºC) in order to save energy and lessen the CO₂ high emission rate common in traditional burning methods- and then submitted to load tests. Among the soils tested, the one with the highest degree of laterization and greater presence of fines constituted the block with the best performance in terms of flexural strength tensions, presenting resistance gains when heated at increasing temperatures, which can indicate that this type of soil has potential towards being used as constructing material.

Keywords: constructive blocks, lateritic soil, MCT methodology, sustainability

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Authors: Sourina Bej

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Since the process of decolonization in 1940, several countries in South Asia have witnessed intra-state conflicts owing to ineffective political governance. The conflicts have remained protracted as the countries have failed to make a holistic transition to a democratic state. Nepal is one such South Asian country facing a turmultous journey from monarchy to republicanism. The paper aims to focus on the democratic transition in the context of Nepal’s political, legal and economic institutions. The presence of autocratic feudalistic and centralised state structure with entrenched socio-economic inequalities has resulted in mass uprising only to see the country slip back to the old order. Even a violent civil war led by the Maoists could not overhaul the political relations or stabilize the democratic space. The paper aims to analyse the multiple political, institutional and operational challenges in the implementation of the peace agreement with the Maoist. Looking at the historical background, the paper will examine the problematic nation-building that lies at the heart of fragile peace process in Nepal. Regional dynamics have played a big role in convoluting the peace-building. The new constitution aimed at conflict resolution brought to the open, deep seated hatred among different ethnic groups in Nepal. Apart from studying the challenges to the peace process and the role of external players like India and China in the political reconstruction, the paper will debate on a viable federal solution to the ethnic conflict in Nepal. If the current government fails to pass a constitution accepted by most ethnic groups, Nepal will remain on the brink of new conflict outbreaks.

Keywords: democratisation, ethnic conflict, Nepal, peace process

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Authors: Rahil Sahragard, Mahmoud Hatami, Rostam Bahadori Khalili

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Diabetes is one of the most important health problems in the world and a chronic disease requiring continuous care and therefore, it is necessary for patients to undergo self-care and nutrition education. This study was conducted to evaluate the effect of nutrition education on the metabolic control of diabetic patients in Tehran in 2015. An experimental study was conducted on 100 patients who had previously been approved by a specialist physician for diabetes and at least one year after their onset. At first, patients without any knowledge of the educational program were selected as sample and from them a checklist containing demographic and specific information about diabetes was filled and were taken three fasting blood glucose and three times fasting blood glucose (5 p.m.) Then, the patients received face-to-face training in the same conditions for 2 weeks in a Mehregan hospital of Tehran, and received 3 months of training, while they were fully monitored and during this time, samples that had a cold or blood pressure-related disease or were admitted to the hospital were excluded from the study. After the end of the study, the checklist was filled again and 3 fasting blood glucose and 3 fasting blood glucose samples were taken, the results were statistically analyzed by MC Nemar's statistical test. The research findings were performed on 100 patients 41.7% male and 58.3% women, the range of age was between 22 and 60 years old, with a duration of diabetes ranging from 1 to 15 years. Abnormal fasting blood glucose from 95% to 48.3% (P <0.0001) and non-fasting blood glucose decreased from 91.6% to 71.2% (P <0.001). Research has shown that training on blood glucose control has been successful, therefore, it is recommended that more research is done in the field of education to help patients with diabetes more comfortable.

Keywords: nutrition education, diabetes, function, insulin, chronic, metabolic control

Procedia PDF Downloads 138

Authors: Giovanni Duran Polo

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Demonstrate the importance of the stages such as Information, Diagnosis, Management, and Intervention is fundamental to have a historical, live, and quality inhabited center. One of the major actions to take is to promote the concept of the management of a historic center with harmonious development. For that, concerned actors should strengthen the concept that said historic center may be the neighborhood of all and for all. The centers of historical cities, presented as any other urban area, social, environmental issues etc; yet they get added value that have no other city neighborhoods. The equity component, either by the urban plan, or environmental quality offered properties of architectural, landscape or some land uses are the differentiating element, while the tool that makes them attractive face pressure exerted by new housing developments or shopping centers. That's why through the experience of working in historical centers, they are declared the actions in heritage areas. This paper will show how the encounter with each of these places are trying to take the phases of information, to gather all the data needed to be closer to the territory with specific data, diagnosis; which allowed the actors to see what state they were, felt how the heart is related to the rest of the city, show what problems affected the situation and what potential it had to compete in a global market. Also, to discuss the importance of the organization, as it is legal and normative basis for it have an order and a concept, when you know what can and what cannot, in an area where the citizen has many myth or history, when he wanted to intervene in protected buildings. It is also appropriate to show how it could develop the intervention phase, where the shares on the tangible elements and intervention for the protection of the heritage property are executed. The management is the final phase which will carry out all that was raised on paper, it's time to orient, explain, persuade, promote, and encourage citizens to take care of the heritage. It is profitable and also an obligation and it is not an insurmountable burden. It has to be said this is the time to pull all the cards to make the historical center and heritage becoming more alive today. It is the moment to make it more inhabited and to transformer it into a quality place, so citizens will cherish and understand the importance of such a place. Inhabited historical centers, endowments and equipment required, with trade quality, with constant cultural offer, with well-preserved buildings and tidy, modern and safe public spaces are always attractive for tourism, but first of all, the place should be conceived for citizens, otherwise everything will be doomed to failure.

Keywords: development, diagnosis, heritage historic center, intervention, management, patrimony

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Authors: Subbarao Pichuka, Amar Balakrishna Tej, Vikas Vemula

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In recent years, the frequency and intensity of urban floods have increased due to climate change all over the world provoking a significant loss in terms of human lives and property. This study investigates the effect of Land Use and Land Cover (LULC) changes and population growth on the urban environmental conditions in the Indian metropolitan city namely Hyderabad. The centennial built-up area data have been downloaded from the Global Human Settlement Layer (GHSL) web portal for various periods (1975 to 2014). The ArcGIS version 10.8 software is employed to convert the GHSL data into shape files and also to calculate the amount of built-up area in the study locations. The decadal population data are obtained from the Census from 1971 to 2011 and forecasted for the required years (1975 and 2014) utilizing the Geometric Increase Method. Next, the analysis has been carried out with respect to the increase in population and the corresponding rise in the built-up area. Further the effects of extreme rainfall events, which exacerbate urban flooding have also been reviewed. Results demonstrate that the population growth was the primary cause of the increase in impervious surfaces in the urban regions. It in turn leads to the intensification of surface runoff and thereby leads to Urban flooding. The built-up area has been doubled from 1975 to 2014 and the population growth has been observed between 109.24% to 400% for the past four decades (1971 to 2014) in the study area (Hyderabad). Overall, this study provides the hindsight on the current urban flooding scenarios, and the findings of this study can be used in the future planning of cities.

Keywords: urban LULC change, urban flooding, GHSL built-up data, climate change, ArcGIS

Procedia PDF Downloads 81

Authors: Sumeeta Khurana, Kirti Megha, Amit Gupta, Rakesh Sehgal

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Background: Amoebic keratitis is a painful vision threatening infection caused by a free living pathogenic amoeba Acanthamoeba. It can be misdiagnosed and very difficult to treat if not suspected early. The epidemiology of Acanthamoeba genotypes causing infection in our geographical area is not yet known to the best of our knowledge. Objective: To characterize Acanthamoeba isolates from amoebic keratitis patients. Methods: A total of 19 isolates obtained from patients with amoebic keratitis presenting to the Advanced Eye Centre at Postgraduate Institute of Medical Education and Research, a tertiary care centre of North India over a period of last 10 years were included. Their corneal scrapings, lens solution and lens case (in case of lens wearer) were collected for microscopic examination, culture and molecular diagnosis. All the isolates were maintained in the Non Nutrient agar culture medium overlaid with E.coli and 13 strains were axenised and maintained in modified Peptone Yeast Dextrose Agar. Identification of Acanthamoeba genotypes was based on amplification of diagnostic fragment 3 (DF3) region of the 18srRNA gene followed by sequencing. Nucleotide similarity search was performed by BLAST search of sequenced amplicons in GenBank database (http//www.ncbi.nlm.nih.gov/blast). Multiple Sequence alignments were determined by using CLUSTAL X. Results: Nine out of 19 Acanthamoeba isolates were found to belong to Genotype T4 followed by 6 isolates of genotype T11, 3 T5 and 1 T3 genotype. Conclusion: T4 is the predominant Acanthamoeba genotype in our geographical area. Further studies should focus on differences in pathogenicity of these genotypes and their clinical significance.

Keywords: Acanthamoeba, free living amoeba, keratitis, genotype, ocular

Procedia PDF Downloads 238

Authors: Shih-Wen Hsiao, Rong-Qi Chen

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In the field of fashion design, 3D Mannequin is a kind of assisting tool which could rapidly realize the design concepts. While the concept of 3D Mannequin is applied to the computer added fashion design, it will connect with the development and the application of design platform and system. Thus, the situation mentioned above revealed a truth that it is very critical to develop a module of 3D Mannequin which would correspond with the necessity of fashion design. This research proposes a concrete plan that developing and constructing a system of 3D Mannequin with Kinect. In the content, ergonomic measurements of objective human features could be attained real-time through the implement with depth camera of Kinect, and then the mesh morphing can be implemented through transformed the locations of the control-points on the model by inputting those ergonomic data to get an exclusive 3D mannequin model. In the proposed methodology, after the scanned points from the Kinect are revised for accuracy and smoothening, a complete human feature would be reconstructed by the ICP algorithm with the method of image processing. Also, the objective human feature could be recognized to analyze and get real measurements. Furthermore, the data of ergonomic measurements could be applied to shape morphing for the division of 3D Mannequin reconstructed by feature curves. Due to a standardized and customer-oriented 3D Mannequin would be generated by the implement of subdivision, the research could be applied to the fashion design or the presentation and display of 3D virtual clothes. In order to examine the practicality of research structure, a system of 3D Mannequin would be constructed with JAVA program in this study. Through the revision of experiments the practicability-contained research result would come out.

Keywords: 3D mannequin, kinect scanner, interactive closest point, shape morphing, subdivision

Procedia PDF Downloads 306

Authors: Sumra Siddique Abbasi, Cheng Shikun

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Biogas technology has rapidly developed in agriculture sector to upgrade and improve the life of farmers by providing them alternative and cost-effective energy source. Main purpose of this study is to understand the advantages of biogas plants by livestock owners either they are household-based livestock owners or may own farms for livestock. Similarly, a pertinent and major purpose of this research is to examine the factors affecting the decision to adopt biogas technologies at the household level. Based on the result, both public and private sector organization can make decisions related to the installation of biogas projects. Biogas is major energy source which can be used as an alternative and renewable energy source. This energy production technology can contribute in uplifting the lifestyle of farmers and can contribute into sustainable development of rural communities in Pakistan. People with livestock in any community in Pakistan can get benefit from biogas plants and it will contribute in sustainable development program which generates socio economic benefits, heath upgradation, cost effective energy source and positive impact on climate change or environmental issues. This study was conductive using survey method and descriptive analysis. One hundred fifty (150) farmers were the respondents who participated in survey. These farmers were from Layyah district of Punjab and were selected using snowball sampling technique. To generate the results, SPSS tool was used for data analysis.

Keywords: biogas plant, animal dunk, renewable energy, pakistan

Procedia PDF Downloads 72

Authors: Wardoyo, Humairoh

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In global competition nowadays, the world economy heavily depends upon high technology and capital intensive industries that are mainly owned by well-established economic and developed countries, such as United States of America, United Kingdom, Japan, and South Korea. Indonesia as a developing country is building its economic activities towards industrial country as well, although a slightly different approach was implemented. For example, similar to the concept of one village one product (OVOP) implemented in Japan, Indonesia also adopted this concept by promoting local traditional products to improve incomes of village people and to enhance local economic activities. Analysis on how OVOP program increase local people’s income and influence customer satisfaction were the objective of this paper. Behavioral intention to purchase and re-purchase, customer satisfaction and promotion are key factors for local products to play significant roles in improving local income and economy of the region. The concepts of OVOP and key factors that influence economic activities of local people and the region will be described and explained in the paper. Results of research, in a case study based on 300 respondents, customers of a local restaurant at Tangerang City, Banten Province of Indonesia, indicated that local product, service quality and behavioral intention individually have significant influence to customer satisfaction; whereas simultaneous tests to the variables indicated positive and significant influence to the behavioral intention through customer satisfaction as the intervening variable.

Keywords: behavioral intention, customer satisfaction, local products, one village one product (OVOP)

Procedia PDF Downloads 296

Authors: Maris Eugênia Dela Rosa, Ana Luiza Menegatti Pavan, Marcela De Oliveira, Diana Rodrigues De Pina, Luis Carlos Vulcano

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In medical veterinary as well as in human medicine, radiological study is essential for a safe diagnosis in clinical practice. Thus, the quality of radiographic image is crucial. In last year’s there has been an increasing substitution of image acquisition screen-film systems for computed radiology equipment (CR) without technical charts adequacy. Furthermore, to carry out a radiographic examination in veterinary patient is required human assistance for restraint this, which can compromise image quality by generating dose increasing to the animal, for Occupationally Exposed and also the increased cost to the institution. The image optimization procedure and construction of radiographic techniques are performed with the use of homogeneous phantoms. In this study, we sought to develop a homogeneous phantom of canine chest to be applied to the optimization of these images for the CR system. In carrying out the simulator was created a database with retrospectives chest images of computed tomography (CT) of the Veterinary Hospital of the Faculty of Veterinary Medicine and Animal Science - UNESP (FMVZ / Botucatu). Images were divided into four groups according to the animal weight employing classification by sizes proposed by Hoskins & Goldston. The thickness of biological tissues were quantified in a 80 animals, separated in groups of 20 animals according to their weights: (S) Small - equal to or less than 9.0 kg, (M) Medium - between 9.0 and 23.0 kg, (L) Large – between 23.1 and 40.0kg and (G) Giant – over 40.1 kg. Mean weight for group (S) was 6.5±2.0 kg, (M) 15.0±5.0 kg, (L) 32.0±5.5 kg and (G) 50.0 ±12.0 kg. An algorithm was developed in Matlab in order to classify and quantify biological tissues present in CT images and convert them in simulator materials. To classify tissues presents, the membership functions were created from the retrospective CT scans according to the type of tissue (adipose, muscle, bone trabecular or cortical and lung tissue). After conversion of the biologic tissue thickness in equivalent material thicknesses (acrylic simulating soft tissues, bone tissues simulated by aluminum and air to the lung) were obtained four different homogeneous phantoms, with (S) 5 cm of acrylic, 0,14 cm of aluminum and 1,8 cm of air; (M) 8,7 cm of acrylic, 0,2 cm of aluminum and 2,4 cm of air; (L) 10,6 cm of acrylic, 0,27 cm of aluminum and 3,1 cm of air and (G) 14,8 cm of acrylic, 0,33 cm of aluminum and 3,8 cm of air. The developed canine homogeneous phantom is a practical tool, which will be employed in future, works to optimize veterinary X-ray procedures.

Keywords: radiation protection, phantom, veterinary radiology, computed radiography

Procedia PDF Downloads 417

Authors: Tobias Schnabel

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Naphthalene and naphthalene similar compounds are a common problem in the indoor air of buildings from the 1960s and 1970s in Germany. Often tar containing roof felt was used under the concrete floor to prevent humidity to come through the floor. This tar containing roof felt has high concentrations of PAH (Polycyclic aromatic hydrocarbon) and naphthalene. Naphthalene easily evaporates and contaminates the indoor air. Especially after renovations and energetically modernization of the buildings, the naphthalene concentration rises because no forced air exchange can happen. Because of this problem, it is often necessary to change the floors after renovation of the buildings. The MFPA Weimar (Material research and testing facility) developed in cooperation a project with LEJ GmbH and Reichmann Gebäudetechnik GmbH. It is a technical solution for the disintegration of naphthalene in naphthalene, similar compounds in indoor air with photocatalytic reforming. Photocatalytic systems produce active oxygen species (hydroxyl radicals) through trading semiconductors on a wavelength of their bandgap. The light energy separates the charges in the semiconductor and produces free electrons in the line tape and defect electrons. The defect electrons can react with hydroxide ions to hydroxyl radicals. The produced hydroxyl radicals are a strong oxidation agent, and can oxidate organic matter to carbon dioxide and water. During the research, new titanium oxide catalysator surface coatings were developed. This coating technology allows the production of very porous titan oxide layer on temperature stable carrier materials. The porosity allows the naphthalene to get easily absorbed by the surface coating, what accelerates the reaction of the heterogeneous photocatalysis. The photocatalytic reaction is induced by high power and high efficient UV-A (ultra violet light) Leds with a wavelength of 365nm. Various tests in emission chambers and on the reformer itself show that a reduction of naphthalene in important concentrations between 2 and 250 µg/m³ is possible. The disintegration rate was at least 80%. To reduce the concentration of naphthalene from 30 µg/m³ to a level below 5 µg/m³ in a usual 50 ² classroom, an energy of 6 kWh is needed. The benefits of the photocatalytic indoor air treatment are that every organic compound in the air can be disintegrated and reduced. The use of new photocatalytic materials in combination with highly efficient UV leds make a safe and energy efficient reduction of organic compounds in indoor air possible. At the moment the air cleaning systems take the step from prototype stage into the usage in real buildings.

Keywords: naphthalene, titandioxide, indoor air, photocatalysis

Procedia PDF Downloads 143

Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

Procedia PDF Downloads 97

Authors: Santosh Thapa, Sankar Gurung

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Chaupadi is a tradition widely practiced in the far and mid-western region of Nepal. It is a practice where girls and women are not allowed to inter the house and touch the food, water and milk during their menstruation period of 4-7 days. They have to spend all the nights during the period in a specific hut (Chhaupadi Goth) which is a bit far from their residence where they faces various kinds of risk and violence like bullying, snakes and insect bite, wild animal attack etc. Sometimes the girls even do not go to school during their menstruation periods. After childbirth, the woman must stay in a cow shed for 11 days in such Chhaupadi practiced areas. This study limits the Achham district of the far western region which is the most vulnerable Chhaupadi practicing district. Several governmental and non-governmental organizations have been involving and spending huge amount of money for capacity building and awareness raising campaign for last 2 decades but still 9 out of 75 Village Development Committees (VDCs) have been partially practicing Chaupadi in the district. This study shows that the school attendance rate of the girls during the period have visibly increased which helps to increase the number of the girl graduation as well. Similarly, the practice of Chhaupadi is one of the reasons for increasing the number of cases of uterus prolapsus and poor reproductive health of women and girls. Triggering tools are the one of the best ways to accelerate the awareness campaign in the VDCs. This study recommends that the local bodies should coordinate and lead the overall awareness campaign program to sustain the Chaupadi free VDCs.

Keywords: awareness campaign, chaupadi practice, gender discrimination, violence

Procedia PDF Downloads 310