Search results for: TB treatment regimens

Authors: Arif İsmailov, Naila Hasanova, Gunay Orujalieva

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Homocysteine (HCY) is an indicator of prognostic value in monitoring regenerative processes in osteoporosis and osteoporotic fractures. The osteoporosis is known to be a serious health and economic problem, especially for women in the postmenopausal period. The study was carried out on patients 45-83 years old divided into 3 groups: group I – 14 patients with osteoporosis , group II – 15 patients with non-osteoporotic fractures, group III – 25 patients with osteoporotic fractures. The control group consisted of practically healthy 14 people. A blood sample was taken at 3 stages to monitor the dynamics of HCY level: on the 1st day before treatment, on the 10th day of treatment and 1 month after it. Blood levels of Hcy were determined at a wavelength of 450 nm by the ELİSA(Cloud Clone Corp.Elisa kits,USA). The statistical evaluation was performed by using SPSS 26.0 program (IBM SPSS Inc., USA).The results showed that on the 1st day before the treatment HCY concentration was statistically increased 2.7 times(PU = 0.108) in group I, 5.6 times (PU <0.001) in group II and 6.5 times (PU <0.001) in group III compared to the control group. Thus, the average value of HCY in group I was 1.76 ± 0.56 μg/ml; in group II – 3.57 ± 0.62 μg/ml; in group III – 4.2 ± 0.50 μg/ml. HCY level increases more sharply after fractures,especially in osteoporotic patients. In treatment period Vitamin D plays an important role in synthesis of the Cystathionine β‐synthase enzyme, which regulates HCY metabolism. Increased Hcy levels could lead to an increase in the risk of fracture through the interference in collagen cross-linking.

Keywords: homocysteine, osteoporosis, osteoporotic fractures, Vitamin D

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Authors: Khalid S. Hashim, Andy Shaw, Rafid Alkhaddar, David Phipps, Ortoneda Pedrola

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Temperature is an essential parameter in the electrocoagulation process (EC) as it governs the solubility of electrodes and the precipitates and the collision rate of particles in water being treated. Although it has been about 100 years since the EC technology was invented and applied in water and wastewater treatment, the effects of temperature on the its performance were insufficiently investigated. Thus, the present project aims to fill this gap by an innovative use of perforated flow columns in the designing of a new EC reactor (ECR1). The new reactor (ECR1) consisted of a Perspex made cylinder container supplied with a flow column consisted of perorated discoid electrodes that made from aluminium. The flow column has been installed vertically, half submerged in the water being treated, inside a plastic cylinder. The unsubmerged part of the flow column works as a radiator for the water being treated. In order to investigate the performance of ECR1; water samples with different initial temperatures (15, 20, 25, 30, and 35 °C) to the ECR1 for 20 min. Temperature of effluent water samples were measured using Hanna meter (Model: HI 98130). The obtained results demonstrated that the ECR1 reduced water temperature from 35, 30, and 25 °C to 24.6, 23.8, and 21.8 °C respectively. While low water temperature, 15 °C, increased slowly to reach 19.1 °C after 15 minutes and kept the same level till the end of the treatment period. At the same time, water sample with initial temperature of 20 °C showed almost a steady level of temperature along the treatment process, where the temperature increased negligibly from 20 to 20.1 °C after 20 minutes of treatment. In conclusion, ECR1 is able to control the temperature of water being treated around the room temperature even when the initial temperature was high (35 °C) or low (15 °C).

Keywords: electrocoagulation, flow column, treatment, water temperature

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Authors: Nouf Al Harthi

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Venous thromboembolism (VTE) is one of the most common causes of hospital-related deaths in critically ill patients. Guidelines recommended VTE prophylaxis with standardized, fixed doses for most patients. The underweight population has limited data to guide the appropriate drug and dosing regimen. The aim of this study was to describe the pattern of VTE prophylaxis dose regimens for underweighted critically ill adult patients and the prevalence of associated VTE and bleeding. This study is a retrospective cohort study, conducted in King Abdulaziz Medical City, Saudi Arabia. It included all critical patients admitted to the intensive care units and were above 14 years old with weight less than 50 kg or BMI of 18.5 kg/m2 or less and were on heparin as VTE prophylaxis for more than 72 hours from January 2016 until January 2020. After screening 270 patients, only 40 patients were included in this study according to our inclusion and exclusion criteria. Only 6 patients (15%) received VTE prophylaxis as an adjusted dose of heparin 2500 U Q12, while the rest of the patients were taking standard dosing of heparin, 5000 U Q12 was given to 21 (52.50%) patients and 5000 U Q8 was given to 13 (32.50%) patients. None of the adjusted doses developed any complications such as VTE or bleeding. There was no significant difference compared with the standard dose group. This study focused on describing the pattern of heparin doses as VTE prophylaxis in underweight patients. We also compared the standard dosing and adjusted dosage of VTE prophylaxis on underweight patients and any complications. There was no significant difference in the complication’s outcome or benefits between the two groups.

Keywords: venous thromboembolism prophylaxis, heparin, underweight patients, adult, critical care units

Procedia PDF Downloads 102

Authors: Indrani Gupta, Leena Vachasiddha, Rakesh Kumar

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Municipal Corporation of Greater Mumbai intends to undertake Mumbai Sewage Disposal (MSDP) for improvement of environment in and around Mumbai city. Sewage generated from the city currently gets partly into the inadequate collection system for treatment and the rest into nearby marine water body through drains. This paper addresses the cost benefit analysis of MSDP works for better compliance of sewage treatment and disposal. Cost benefit analysis indicates that the investment in sewage treatment is economically beneficial and will provide immense social, environmental, health and economic benefits. Monetary values of positive benefits such as avoided health costs, enhanced fish catches and improved tourism have been quantified. The total capital cost of the project is estimated to be about INR 51,510 million and operation and maintenance cost is about INR 2240.6 million per year. The cost benefit analysis indicates that a benefit of about 25,882 million per year can be achieved due to the implementation of this project. Other than these benefits, better marine ecosystem quality; higher property cost; improved recreational opportunities were not included because of lack of information.

Keywords: waste water treatment, cost-benefit analysis, health, tourism, fisheries

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Authors: Olais A. Ingrid, Peraza G. Leydi, Estrella C. Damaris

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Breast cancer is the most common among women worldwide; the different treatments can bring sequels that directly affect the quality of life, such as lymphedema. The objective was to determine if there is presence of lymphedema secondary to breast cancer in Yucatecan women. It was an observational, analytical, cross-sectional study, 92 women were included who met the following criteria: women with surgical treatment for unilateral: breast cancer, aged between 25 and 65 years old, minimum 6 weeks after unilateral breast surgery and have completed any type of chemotherapy or adjuvant radiotherapy treatment for breast cancer. The evaluation was through indirect measurement volume by circometry to determine the presence of lymphedema. 23% of women had lymphedema grade I. It related to the presence of some of the symptoms like stiffness, swelling, decreased range of motion and feeling of heaviness in the arm of the operated side of the breast. It is important to determine the presence of lymphedema to perform physical therapy treatment.

Keywords: breast cancer, lymphedema, physical therapy, Yucatan

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Authors: Anna Rudzińska, Katarzyna Szklener, Pola Juchaniuk, Anna Rodzajweska, Katarzyna Machulska-Ciuraj, Monika Rychlik- Grabowska, Michał łOziński, Agnieszka Kolak-Bruks, SłAwomir Mańdziuk

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Introduction: Immune checkpoint inhibition (ICI) belongs to the modern forms of anti-cancer treatment. Due to the constant development and continuous research in the field of ICI, many aspects of the treatment are yet to be discovered. One of the less researched aspects of ICI treatment is the influence of the adverse effects on the treatment success rate. It is suspected that adverse events in the course of the ICI treatment indicate a better response rate and correlate with longer progression-free- survival. Methodology: The research was conducted with the usage of the documentation of the Department of Clinical Oncology and Chemotherapy. Data of the patients with a lung cancer diagnosis who were treated between 2019-2022 and received ICI treatment were analyzed. Results: Out of over 133 patients whose data was analyzed, the vast majority were diagnosed with non-small cell lung cancer. The majority of the patients did not experience adverse effects. Most adverse effects reported were classified as grade 1 or grade 2 according to CTCAE classification. Most adverse effects involved skin, thyroid and liver toxicity. Statistical significance was found for the adverse effect incidence and overall survival (OS) and progression-free survival (PFS) (p=0,0263) and for the time of toxicity onset and OS and PFS (p<0,001). The number of toxicity sites was statistically significant for prolonged PFS (p=0.0315). The highest OS was noted in the group presenting grade 1 and grade 2 adverse effects. Conclusions: Obtained results confirm the existence of the prolonged OS and PFS in the adverse-effects-charged patients, mostly in the group presenting mild to intermediate (Grade 1 and Grade 2) adverse effects and late toxicity onset. Simultaneously our results suggest a correlation between treatment response rate and the toxicity grade of the adverse effects and the time of the toxicity onset. Similar results were obtained in several similar research conducted - with the proven tendency of better survival in mild and moderate toxicity; meanwhile, other studies in the area suggested an advantage in patients with any toxicity regardless of the grade. The contradictory results strongly suggest the need for further research on this topic, with a focus on additional factors influencing the course of the treatment.

Keywords: adverse effects, immunotherapy, lung cancer, PD-1/PD-L1 inhibitors

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Authors: Sushma Yadav, Anil K. Saroha

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Complex industrial effluent generated from chemical industry is contaminated with toxic and hazardous organic compounds and not amenable to direct biological treatment. To effectively remove many toxic organic pollutants has made it evident that new, compact and more efficient systems are needed. Catalytic Wet Air Oxidation (CWAO) is a promising treatment technology for the abatement of organic pollutants in wastewater. A lot of information is available on using CWAO for the treatment of synthetic solution containing single organic pollutant. But the real industrial effluents containing multi-component mixture of organic compounds were less studied. The main objective of this study is to use the CWAO process for converting the organics into compounds more amenable to biological treatment; complete oxidation may be too expensive. Therefore efforts were made in the present study to explore the potential of alumina based Platinum (Pt) catalyst for the treatment of industrial organic raffinate containing toxic constituents like ammoniacal nitrogen, pyridine etc. The catalysts were prepared by incipient wetness impregnation method and characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX) and BET (Brunauer, Emmett, and Teller) surface area. CWAO experiments were performed at atmospheric pressure and (30 °C - 70 °C) temperature conditions and the results were evaluated in terms of COD removal efficiency. The biodegradability test was performed by BOD/COD ratio for checking the toxicity of the industrial wastewater as well as for the treated water. The BOD/COD ratio of treated water was significantly increased and signified that the toxicity of the organics was decreased while the biodegradability was increased, indicating the more amenability towards biological treatment.

Keywords: alumina based pt catalyst, BOD/COD ratio, catalytic wet air oxidation, COD removal efficiency, industrial organic raffinate

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Authors: Mohammad Hossain Validad

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Background and Aim: Epidemic keratoconjunctivitis is a type of conjunctivitis caused by adenoviruses that can spread rapidly through direct and indirect contact. The aim of this study was to evaluate the therapeutic effects of Povidone-Iodine 0.4% and 0.2% in improving the symptoms and signs of patients with epidemic keratoconjunctivitis. Materials and Methods: In this clinical trial study, 60 patients with a mean age of 27.8±8.4 years who were eligible for inclusion criteria were randomly divided into three groups. The first group received eye drops of Povidone-Iodine 0.4% and betamethasone 0.1%, the second group received PovidoneIodine 0.2% and betamethasone 0.1% and the third group received betamethasone 0.1%. Follow-ups were on the first, fourth, seventh and tenth days after starting treatment. Parameters examined at each examination were hyperaemia, mucopurulent discharge, eyelid edema, hemorrhage, and subepithelial infiltration. Results: The results showed that mucopurulent discharge on the fourth day of the examination (P = 0.005) and the seventh day of the examination (P = 0.001) were significantly different in the three treatment groups. Sub-epithelial infiltration on the tenth day after treatment did not show a significant difference in the 3 groups (P = 0.287). Conclusion: Based on the results of this study, Povidone-Iodine is more effective in relieving some of signs of EKC, such as reduced mucopurulent discharge than steroids alone.

Keywords: EKC, topical bethadine, adenovirus, sub epithelial opacity

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Authors: Muhammad Yusuf Abduh, Robert Manurung, Hero Jan Heeres

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Biodiesel can be produced in small scale mobile units which are designed with local input and demand. Unlike the typical biodiesel production plants, mobile biodiesel unit consiss of a biodiesel production facility placed inside a standard cargo container and mounted on a truck so that it can be transported to a region near the location of raw materials. In this paper, we review the existing concept and unit for the development of community-scale and mobile production of biodiesel. This includes the main reactor technology to produce biodiesel as well as the pre-treatment prior to the reaction unit. The pre-treatment includes the oil-expeller unit to obtain oil from the oilseeds as well as the quality control of the oil before it enters the reaction unit. This paper also discusses the post-treatment after the production of biodiesel. It includes the refining and purification of biodiesel to meet the product specification set by the biodiesel industry.

Keywords: biodiesel, community scale, mobile biodiesel unit, reactor technology

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Authors: Rohit Sane, Snehal Dongre, Pravin Ghadigaonkar, Rahul Mandole

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The present study was designed to evaluate efficacy of heart failure reversal therapy (HFRT) that uses herbal procedure (panchakarma) and allied therapies, in chronic heart failure (CHF) patients with low ejection fraction. Methods: This efficacy study was conducted in CHF patients (aged: 25-65 years, ejection fraction (EF) < 30%) wherein HFRT (60-75 minutes) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara(concoction dripping treatment) and basti(enema) was administered twice daily for 7 days. During this therapy and next 30 days, patients followed the study dinarcharya and were prescribed ARJ kadha in addition to their conventional treatment. The primary endpoint of this study was evaluation of maximum aerobic capacity uptake (MAC) as assessed by 6-minute walk distance (6MWD) using Cahalins equation from baseline, at end of 7 day treatment, follow-up after 30 days and 90 days. EF was assessed by 2D Echo at baseline and after 30 days of follow-up. Results: CHF patients with < 30% EF (N=52, mean [SD] age: 58.8 [10.8], 85% men) were enrolled in the study. There was a 100% compliance to study therapy. A significant improvement was observed in MAC levels (7.11%, p =0.029), at end of 7 day therapy as compared to baseline. This improvement was maintained at two follow-up visits. Moreover, ejection fraction was observed to be increased by 6.38%, p=0,012 as compared to baseline at day 7 of the therapy. Conclusions: This 90 day follow up study highlights benefit of HFRT, as a part of maintenance treatment for CHF patients with reduced ejection fraction.

Keywords: chronic heart failure, functional capacity, heart failure reversal therapy, oxygen uptake, panchakarma

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Authors: Mahmoud M. Tash

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The present study was undertaken to investigate the effect of aging parameters (time and temperature) on the mechanical properties of Be-and/or Zr- treated Al-Mg-Zn (7075) alloys. Ultimate tensile strength, 0.5% offset yield strength and % elongation measurements were carried out on specimens prepared from cast and heat treated 7075 alloys containing Be and/or Zr. Different aging treatment were carried out for the as solution treated (SHT) specimens. The specimens were aged at different conditions; Natural and artificial aging was carried out at room temperature, 120C, 150C, 180C and 220C for different periods of time. Duplex aging was performed for SHT conditions (pre-aged at different time and temperature followed by high temperature aging). Ultimate tensile strength, yield strength and % elongation data results as a function of different aging parameters are analysed. A statistical design of experiments (DOE) approach using fractional factorial design is applied to acquire an understanding of the effects of these variables and their interactions on the mechanical properties of Be- and/or Zr- treated 7075 alloys. Mathematical models are developed to relate the alloy mechanical properties with the different aging parameters.

Keywords: casting aging treatment, mechanical properties, Al-Mg-Zn alloys, Be- and/or Zr-treatment, experimental correlation

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Authors: Rajeev Ravindran, Amit K. Jaiswal

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Lignocellulose is the largest reservoir of inexpensive, renewable source of carbon. It is composed of lignin, cellulose and hemicellulose. Cellulose and hemicellulose is composed of reducing sugars glucose, xylose and several other monosaccharides which can be metabolised by microorganisms to produce several value added products such as biofuels, enzymes, aminoacids etc. Enzymatic treatment of lignocellulose leads to the release of monosaccharides such as glucose and xylose. However, factors such as the presence of lignin, crystalline cellulose, acetyl groups, pectin etc. contributes to recalcitrance restricting the effective enzymatic hydrolysis of cellulose and hemicellulose. In order to overcome these problems, pre-treatment of lignocellulose is generally carried out which essentially facilitate better degradation of lignocellulose. A range of pre-treatment strategy is commonly employed based on its mode of action viz. physical, chemical, biological and physico-chemical. However, existing pretreatment strategies result in lower sugar yield and formation of inhibitory compounds. In order to overcome these problems, we proposes a novel pre-treatment, which utilises the superior oxidising capacity of alkaline potassium permanganate assisted by ultra-sonication to break the covalent bonds in spent coffee waste to remove recalcitrant compounds such as lignin. The pre-treatment was conducted for 30 minutes using 2% (w/v) potassium permanganate at room temperature with solid to liquid ratio of 1:10. The pre-treated spent coffee waste (SCW) was subjected to enzymatic hydrolysis using enzymes cellulase and hemicellulase. Shake flask experiments were conducted with a working volume of 50mL buffer containing 1% substrate. The results showed that the novel pre-treatment strategy yielded 7 g/L of reducing sugar as compared to 3.71 g/L obtained from biomass that had undergone dilute acid hydrolysis after 24 hours. From the results obtained it is fairly certain that ultrasonication assists the oxidation of recalcitrant components in lignocellulose by potassium permanganate. Enzyme hydrolysis studies suggest that ultrasound assisted alkaline potassium permanganate pre-treatment is far superior over treatment by dilute acid. Furthermore, SEM, XRD and FTIR were carried out to analyse the effect of the new pre-treatment strategy on structure and crystallinity of pre-treated spent coffee wastes. This novel one-step pre-treatment strategy was implemented under mild conditions and exhibited high efficiency in the enzymatic hydrolysis of spent coffee waste. Further study and scale up is in progress in order to realise future industrial applications.

Keywords: spent coffee waste, alkaline potassium permanganate, ultra-sonication, physical characterisation

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Authors: Dorothy Chyung

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In the psychiatric interview, the mental status exam begins with an assessment of the patient's appearance, noting aspects such as grooming and hygiene. However, it is not well established whether further examination of a patient's attire can provide further useful information. The popular assumption is that those who are mentally unwell will manifest this in unusual clothing. In the moral treatment of the 19th century, proper clothing was also seen as a pivotal therapeutic concern. This project examines assumptions about clothing, both as a reflection of and treatment for psychopathology. The methodology considers the opinions expressed in 19th century art and journals, as well as asylum rules, in comparison to contemporary psychiatric practice and research evidence. Per moral treatment in the 19th century, self-discipline and a proper environment would cure insanity. Madness was evident in the opposite of these ideals—such as ragged or ‘improper’ clothing—and rules about attire delineated the most correct (i.e. sane) ways to dress. These rules applied not only for the patients but also for staff. Despite these ideals, accusations were made that asylums, in fact, dressed patients to look more mentally unwell and further removed patients’ agency. Current practice in psychiatric hospitals retains remnants of moral treatment. Patients are expected to dress ‘appropriately’ while retaining some choice to build self-esteem, with arguments about safety being used to justify the removal of choice. Meanwhile, staff is expected to dress professionally and as role models, based on the assumption that conservative dress is least pathological. Research on this subject is limited, and there is little evidence that discrete psychiatric diagnoses manifest in the particular dress, nor that conservative dress would result in a reduction in pathology. Dressing unusually has become a privilege granted only to those without association with mental illness.

Keywords: fashion, history of psychiatry, medical humanities, mental health treatment

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Authors: Farnaz Firuzian, Farhad Choobdar, Ali Mazouri

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As Very Low Birth Weight (VLBW) neonates cannot tolerate enteral feeding, parenteral nutrition (PN) must be administered shortly after birth. To find an optimal combination of nutrition, in this study, we compare administering high glucose versus high protein intake as a component of total parenteral nutrition (TPN) to test their effect on birth weight (BW) regain in VLBW. This study employs a multi-arm randomized trial: 145 newborns with BW < 1500 g were randomized to control (C) or experimental groups: high glucose (G) or high protein (P). All samples in each group received the same TPN regimens except glucose and protein intake: Glocuse was provided by dextrose water (DW) serum: 7-15 g/kg/d (10% DW) in groups C and P versus 8.75-18.75 g/kg/d (12.5% DW) in group G. Protein provided by amino acids 3 g/kg/d for groups C and G versus 4 g/kg/d for group P. Outcomes (weight, height, and head circumference) was monitored on a daily basis until the BW was regained. Data has been gathered recently and is being processed. We hypothesize that neonates with higher amino acid intake will result in sooner BW regain than other groups. The result will be presented at the conference. The findings of this study not only can help optimize nutrition, cost reduction, and shorter NICU admission of VLBW neonates at the hospital level but eventually contribute to reduced healthcare-associated infections (HAIs) and an improved health economy.

Keywords: very low birth weight neonates, weight gain, parenteral nutrition, glucose, amino acids

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Authors: Sukla Saha, Alok Sinha

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Acid mine drainage (AMD) refers to the production of acidified water from abandoned mines and active mines as well. The reason behind the generation of this kind of acidified water is the oxidation of pyrites present in the rocks in and around mining areas. Thiobacillus ferrooxidans, which is a sulfur oxidizing bacteria, helps in the oxidation process. AMD is extremely acidic in nature, (pH 2-3) with high concentration of several trace and heavy metals such as Fe, Al, Zn, Mn, Cu and Co and anions such as chloride and sulfate. AMD has several detrimental effect on aquatic organism and environment. It can directly or indirectly contaminate the ground water and surface water as well. The present study considered the treatment of AMD with metallurgical slag, which is a waste material. Slag helped to enhance the pH of AMD to 8.62 from 1.5 with 99% removal of trace metals such as Fe, Al, Mn, Cu and Co. Metallurgical slag was proven as efficient neutralizing material for the treatment of AMD.

Keywords: acid mine drainage, Heavy metals, metallurgical slag, Neutralization

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Authors: Philippa C. Ojimelukwe, Felix C. Okpalanma, Emmanuel A. Mazi

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The carotenoid content, vitamins (ascorbic acid, riboflavin, thiamin, niacin and vitamin K) and mineral contents (K, Ca, Mg, Zn and Fe) of raw, cooked (moist heat treatment) and stored Gnetum africanum and Pterocarpus mildbraedii leaves were investigated in the present research. Raw G. africanum contained higher total carotenoids (246.93µg/g edible portion) than P. mildbraedii (83.53µg/g edible portion) However, moist heat treatment significantly improved the total carotenoid content of P. mildbraedii. The carotenoid profiles of P. mildbraedii and G. africanum showed improved contents of beta cryptoxanthin , 9-cis, 11-cis and 13 cis beta carotenes due to moist heat treatment. Lutein contents of the two green leafy vegetables were quite high in raw, heat treated and stored samples. The two green leafy vegetables were good sources of vitamin K (118-120 µg). Moist heat treatment significantly (p < 0.05) increased the mineral contents of P.mildbraedii and G. africanum. The vitamin contents were reduced. Storage at ambient temperature (30oC) in the dark led to good retention of the minerals but not the vitamins.

Keywords: Gnetum africanum, Pterocarpus mildbraedii, carotenoid profile, vitamins, minerals

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Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan

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Background: Endothelial Progenitor Cells (EPCs) are depleted and contribute to increased cardiovascular (CV) risk in rheumatoid arthritis (RA). Statins exert a protective effect in CAD partly by promoting EPC mobilization. This vasculoprotective effect of statin has not yet been investigated in RA. We aimed to investigate the effect of rosuvastatin on EPCs in RA. Methods: 50 RA patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=25) and placebo (n=25) as an adjunct to existing stable antirheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures included DAS28, CRP and ESR were measured at baseline and after treatment. Lipids and pro-inflammatory cytokines (TNF-α, IL-6, and IL-1) were estimated at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. At baseline, EPCs inversely correlated with DAS28 and TNF-α in both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin but did not show significant change with placebo. Rosuvastatin exerted positive effect on lipid spectrum: lowering total cholesterol, LDL, non HDL and elevation of HDL as compared with placebo. At 6 months, DAS28, ESR, CRP, TNF-α and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and DAS28, CRP, TNF-α, and IL-6 after treatment with rosuvastatin. Conclusion: First study to show that rosuvastatin improves inflammation and EPC biology in RA possibly through its anti-inflammatory and lipid lowering effect. This beneficial effect of rosuvastatin may provide a novel strategy to prevent cardiovascular events in RA.

Keywords: RA, Endothelial Progenitor Cells, rosuvastatin, cytokines

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Authors: Smita Lakhotia, C. Kew, S. H. M. Siraj, B. Chern

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Up to 50% of those with endometriosis may suffer from infertility due to either distorted pelvic anatomy/impaired oocyte release or inhibit ovum pickup and transport, altered peritoneal function, endocrine and anovulatory disorders, including LUF, impaired implantation, progesterone resistance or decreased levels of cellular immunity. The dilemma continues as to whether the surgery or IVF is the optimal management for such recurrent endometriomas. The core question is whether surgery adds anything of value for infertile women with recurrent endometriosis or not. Complete and detailed information on risks and benefits of treatment alternatives must be offered to patients, giving a realistic estimate of chances of success of repetitive surgery and of multiple IVF cycles in order to allow unbiased choices between different possible optionsAn individualized treatment plan should be developed taking into account patient age, duration of infertility, previous pregnancies and specific clinical conditions and wish.

Keywords: recurrent endometriosis, infertility, oocyte release, pregnancy

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Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

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INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

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Authors: M. Tarik Boyraz, M. Bilge Imer

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Conventionally cast nickel-based super alloys, such as commercial alloy IN 738 LC, are widely used in manufacturing of industrial gas turbine blades. With carefully designed microstructure and the existence of alloying elements, the blades show improved mechanical properties at high operating temperatures and corrosive environment. The aim of this work is to model and estimate these mechanical properties of IN 738 LC alloy solely based on simulations for projected heat treatment conditions or service conditions. The microstructure (size, fraction and frequency of gamma prime- γ′ and carbide phases in gamma- γ matrix, and grain size) of IN 738 LC needs to be optimized to improve the high temperature mechanical properties by heat treatment process. This process can be performed at different soaking temperature, time and cooling rates. In this work, micro-structural evolution studies were performed experimentally at various heat treatment process conditions, and these findings were used as input for further simulation studies. The operation time, soaking temperature and cooling rate provided by experimental heat treatment procedures were used as micro-structural simulation input. The results of this simulation were compared with the size, fraction and frequency of γ′ and carbide phases, and grain size provided by SEM (EDS module and mapping), EPMA (WDS module) and optical microscope for before and after heat treatment. After iterative comparison of experimental findings and simulations, an offset was determined to fit the real time and theoretical findings. Thereby, it was possible to estimate the final micro-structure without any necessity to carry out the heat treatment experiment. The output of this microstructure simulation based on heat treatment was used as input to estimate yield stress and creep properties. Yield stress was calculated mainly as a function of precipitation, solid solution and grain boundary strengthening contributors in microstructure. Creep rate was calculated as a function of stress, temperature and microstructural factors such as dislocation density, precipitate size, inter-particle spacing of precipitates. The estimated yield stress values were compared with the corresponding experimental hardness and tensile test values. The ability to determine best heat treatment conditions that achieve the desired microstructural and mechanical properties were developed for IN 738 LC based completely on simulations.

Keywords: heat treatment, IN738LC, simulations, super-alloys

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Authors: Francesca Favero, Despina Learmonth

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Carbohydrate addiction is said to be the sustained dependence on hyperpalatable foods rich in carbohydrates and sugar. This addiction manifests in increased consumption of carbohydrates through binging: a behaviour typically associated with eating disorders. There is a lack of consensus amongst relevant experts as to whether carbohydrates are physiologically or psychologically addictive. With an increased focus on carbohydrate addiction, an outpatient treatment programme, HELP, has been established in Cape Town, South Africa, to specifically address this issue. This research aimed to explore, pre-and post-intervention, the possible presence of, and subsequent shifts in, the maintaining mechanisms identified in the transdiagnostic model for eating disorders. However, the potential for the emergence of other perpetuating factors was not discounted and the nature of the analysis allowed for this possibility. Eight women between the ages of twenty-two and fifty, who had completed the outpatient treatment programme in the last six months, were interviewed. They were asked to speak retrospectively about their personal difficulties, eating and food, and their experience of the treatment. Thematic analysis was employed to identify themes arising from the data. Five themes congruent with the transdiagnostic model’s factors emerged: over-evaluation of weight and shape, core low self-esteem, interpersonal difficulties, clinical perfectionism and mood intolerance. A variety of sub-themes, elaborating upon the various ways in which the disordered eating was maintained, also emerged from the data. Shifts in these maintaining mechanisms were identified. Although not necessarily indicative of recovery, the results suggest that the outpatient HELP programme had a positive overall influence on the participants; and that the transdiagnostic model may be useful in understanding and guiding the treatment of clients who engage in this type of treatment programme.

Keywords: eating disorders, binge eating disorder, carbohydrate addiction, transdiagnostic model, maintaining mechanisms, thematic analysis, outpatient treatment

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Authors: Victoria Eugenia Garnacho-Garnacho, Elena Sonsoles Rodriguez-Lopez, Raquel Delgado-Delgado, Alvaro Otero-Campos, Jesus Guodemar-Perez, Angelo Michelle Vagali, Juan Pablo Hervas-Perez

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Asthma is a heterogeneous disease which has always had a drug treatment. Osteopathic treatment that we propose is aimed, seen through a dorsal manipulation (Dog Technic D1-D4) and a technique for diaphragm (Longitudinal Stroke) forced expiratory flow in spirometry changes there are in particular that there is an increase in the volumes of the Peak Flow and Post intervention and effort and that the application of these two techniques together is more powerful if we applied only a Longitudinal (Stroke). Also rating if this type of treatment will have repercussions on breathlessness, a very common symptom in asthma. And finally to investigate if provided vertebra pain decreased after a manipulation. Methods—Participants were recruited between students and professors of the University, aged 18-65, patients (n = 18) were assigned randomly to one of the two groups, group 1 (longitudinal Stroke and manipulation dorsal Dog Technic) and group 2 (diaphragmatic technique, Longitudinal Stroke). The statistical analysis is characterized by the comparison of the main indicator of obstruction of via area PEF (peak expiratory flow) in various situations through the peak flow meter Datospir Peak-10. The measurements were carried out in four phases: at rest, after the stress test, after the treatment, after treatment and the stress test. After each stress test was evaluated, through the Borg scale, the level of Dyspnea on each patient, regardless of the group. In Group 1 in addition to these parameters was calculated using an algometer spinous pain before and after the manipulation. All data were taken at the minute. Results—12 Group 1 (Dog Technic and Longitudinal Stroke) patients responded positively to treatment, there was an increase of 5.1% and 6.1% of the post-treatment PEF and post-treatment, and effort. The results of the scale of Borg by which we measure the level of Dyspnea were positive, a 54.95%, patients noted an improvement in breathing. In addition was confirmed through the means of both groups group 1 in which two techniques were applied was 34.05% more effective than group 2 in which applied only a. After handling pain fell by 38% of the cases. Conclusions—The impact of the technique of Dog-Technic for D1-D4 and the Longitudinal Stroke technique for diaphragm in the volumes of peak expiratory flow (PEF) in asthmatic patients were positive, there was a change of the PEF Post intervention and post-treatment, and effort and showed the most effective group in which only a technique was applied. Furthermore this type of treatment decreased facilitated vertebrae pain and was efficient in the improvement of Dyspnea and the general well-being of the patient.

Keywords: ANS, asthma, manipulation, manual therapy, osteopathic

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Authors: Vusumzi E. Pakade, Themba D. Ntuli, Augustine E. Ofomaja

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Macadamia nutshell biosorbents treated in three different methods (raw Macadamia nutshell powder (RMN), acid-treated Macadamia nutshell (ATMN) and base-treated Macadamia nutshell (BTMN)) were investigated for the adsorption of Cr(VI) from aqueous solutions. Fourier transform infrared spectroscopy (FT-IR) spectra of free and Cr(VI)-loaded sorbents as well as thermogravimetric analysis (TGA) revealed that the acid and base treatments modified the surface properties of the sorbents. The optimum conditions for the adsorption of Cr(VI) by sorbents were pH 2, contact time 10 h, adsorbent dosage 0.2 g L-1, and concentration 100 mg L-1. The different treatment methods altered the surface characteristics of the sorbents and produced different maximum binding capacities of 42.5, 40.6 and 37.5 mg g-1 for RMN, ATMN and BTMN, respectively. The data was fitted into the Langmuir, Freundlich, Redlich-Peterson and Sips isotherms. No single model could clearly explain the data perhaps due to the complexity of process taking place. The kinetic modeling results showed that the process of Cr(VI) biosorption with Macadamia sorbents was better described by a process of chemical sorption in pseudo-second order. These results showed that the three treatment methods yielded different surface properties which then influenced adsorption of Cr(VI) differently.

Keywords: biosorption, chromium(VI), isotherms, Macadamia, reduction, treatment

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Authors: Dessie Tibebe, Muluken Asmare, Marye Mulugeta, Yezbie Kassa, Zerubabel Moges, Dereje Yenealem, Tarekegn Fentie, Agmas Amare

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The performance of electrocoagulation (EC) using Aluminium electrodes for the treatment of effluent-containing chromium metal using a fixed bed electrochemical batch reactor was studied. In the present work, the efficiency evaluation of EC in removing physicochemical and heavy metals from real industrial tannery wastewater in the Amhara region, collected from Bahirdar, Debre Brihan, and Haik, was investigated. The treated and untreated samples were determined by AAS and ICP OES spectrophotometers. The results indicated that selected heavy metals were removed in all experiments with high removal percentages. The optimal results were obtained regarding both cost and electrocoagulation efficiency with initial pH = 3, initial concentration = 40 mg/L, electrolysis time = 30 min, current density = 40 mA/cm2, and temperature = 25oC favored metal removal. The maximum removal percentages of selected metals obtained were 84.42% for Haik, 92.64% for Bahir Dar and 94.90% for Debre Brihan. The sacrificial electrode and sludge were characterized by FT-IR, SEM and XRD. After treatment, some metals like chromium will be used again as a tanning agent in leather processing to promote a circular economy.

Keywords: electrochemical, treatment, aluminum, tannery effluent

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Authors: Kamran Yazdanbakhsh, Somayeh Mahmoudi

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Three reasons make good use of the decision theory in medicine: 1. Increased medical knowledge and their complexity makes it difficult treatment information effectively without resorting to sophisticated analytical methods, especially when it comes to detecting errors and identify opportunities for treatment from databases of large size. 2. There is a wide geographic variability of medical practice. In a context where medical costs are, at least in part, by the patient, these changes raise doubts about the relevance of the choices made by physicians. These differences are generally attributed to differences in estimates of probabilities of success of treatment involved, and differing assessments of the results on success or failure. Without explicit criteria for decision, it is difficult to identify precisely the sources of these variations in treatment. 3. Beyond the principle of informed consent, patients need to be involved in decision-making. For this, the decision process should be explained and broken down. A decision problem is to select the best option among a set of choices. The problem is what is meant by "best option ", or know what criteria guide the choice. The purpose of decision theory is to answer this question. The systematic use of decision models allows us to better understand the differences in medical practices, and facilitates the search for consensus. About this, there are three types of situations: situations certain, risky situations, and uncertain situations: 1. In certain situations, the consequence of each decision are certain. 2. In risky situations, every decision can have several consequences, the probability of each of these consequences is known. 3. In uncertain situations, each decision can have several consequences, the probability is not known. Our aim in this article is to show how decision theory can usefully be mobilized to meet the needs of physicians. The decision theory can make decisions more transparent: first, by clarifying the data systematically considered the problem and secondly by asking a few basic principles should guide the choice. Once the problem and clarified the decision theory provides operational tools to represent the available information and determine patient preferences, and thus assist the patient and doctor in their choices.

Keywords: decision making, medicine, treatment strategies, patient

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Authors: Ghoul Rachid Brahim

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Introduction: Back pain is a real public health problem with a significant socio-economic impact. It is the consequence of a degeneration of the lumbar intervertebral disc (IVD). This often asymptomatic pathology is compatible with an active life. As soon as it becomes symptomatic, conservative treatment is recommended in the majority of cases. The physical or functional disability is resistant to well-monitored conservative treatment, which justifies a surgical alternative which imposes a well-studied reflection on the objectives to be achieved. Objective: Evaluate the indication and short and medium term contribution of surgery in the management of painful degenerative lumbar disc disease. To prove the effectiveness of surgical treatment in the management of painful lumbar degenerative disc disease. Materials and methods: This is a prospective descriptive mono-centric study without comparison group, comprising a series of 104 patients suffering from lumbar painful degenerative disc disease treated surgically. Retrospective analysis of data collected prospectively. Comparison between pre and postoperative clinical status, by pain self-assessment scores and on the impact on pre and postoperative quality of life (3, 6 to 12 months). Results: This study showed that patients who received surgical treatment had great improvements in symptoms, function and several health-related quality of life in the first year after surgery. Conclusions: The surgery had a significantly positive impact on patients' pain, disability and quality of life. Overall, 97% of the patients were satisfied.

Keywords: degenerative disc disease, intervertebral disc, several health-related quality, lumbar painful

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Authors: Malith Premarathne, Shehan Bandara, Kaushalya G. Batawala, Thilini U. Ariyadasa

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The rapid depletion of fossil fuel supplies and the emission of carbon dioxide by their continued combustion have paved the way for increased production of carbon-neutral biodiesel from naturally occurring oil sources. The high biomass growth rate and lipid production of microalgae make it a viable source for biodiesel production compared to conventional feedstock. In Sri Lanka, the production of biodiesel by employing indigenous microalgae species is at its emerging stage. This work was an attempt to compare the various pre-treatment methods before extracting lipids such as autoclaving, microwaving and sonication. A mixed culture of microalgae predominantly consisting of Chlorella sp. was obtained from Beire Lake which is an algae rich, organically polluted water body located in Colombo, Sri Lanka. After each pre-treatment method, a standard solvent extraction using Bligh and Dyer’s method was used to compare the total lipid content in percentage dry weight (% dwt). The fatty acid profiles of the oils extracted with each pretreatment method were analyzed using gas chromatography-mass spectrometry (GC-MS). The properties of the biodiesels were predicted by Biodiesel Analyzer© Version 1.1, in order to compare with ASTM 6751-08 biodiesel standard.

Keywords: biodiesel, lipid extraction, microalgae, pre-treatment

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Authors: Manal A. Mohsen, Ahmed Tawfik

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Hydrogen production from cake wastewater by anaerobic dark fermentation via upflow anaerobic staged reactor (UASR) was investigated in this study. The reactor was continuously operated for four months at constant hydraulic retention time (HRT) of 21.57 hr, PH value of 6 ± 0.6, temperature of 21.1°C, and organic loading rate of 2.43 gCOD/l.d. The hydrogen production was 5.7 l H₂/d and the hydrogen yield was 134.8 ml H₂ /g COD_removed. The system showed an overall removal efficiency of TCOD, TBOD, TSS, TKN, and Carbohydrates of 40 ± 13%, 59 ± 18%, 84 ± 17%, 28 ± 27%, and 85 ± 15% respectively during the long term operation period. Based on the available results, the system is not sufficient for the effective treatment of cake wastewater, and the effluent quality of UASR is not complying for discharge into sewerage network, therefore a post treatment is needed (not covered in this study).

Keywords: cake wastewater industry, chemical oxygen demand (COD), hydrogen production, up-flow anaerobic staged reactor (UASR)

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Authors: Rajesh Panda, Jimi Tjong, Sanjay K. Nayak, Mohini M. Sain

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The aim of this manuscript was to evaluate the effect of chemical treatment of sisal fibre on the mechanical and viscoelastic properties of bio based epoxy/fibre composites. The composite samples were manufactured through a vacuum infusion process by adding alkyl phenols from cashew nutshell liquid (CSNL). Changes in the chemical structure of the sisal fibres resulting from the treatments were analyzed by Fourier transform infrared spectroscopy (FTIR). Both alkali and silane treatments produced enhancements in the mechanical properties of sisal fibre bundles. The alkali treatment, when combined with the silane treatment, the mechanical properties of epoxy composites notably improved (13%) in comparison to untreated sisal fibre reinforced composites.This was attributed to an enhanced fibre/matrix interface. The incorporation of CSNL into the sisal/epoxy composite enhanced the fibre-matrix interfacial properties because of the addition of -OH groups to the epoxy matrix. The incorporation of sisal fibre imparts stiffness to the epoxy matrix.

Keywords: phenalkamine, sisal fiber, vacuum infusion, cashew nutshell liquid, cashew nutshell liquid (CSNL)

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

Procedia PDF Downloads 251