Search results for: therapies for hearing loss management

Authors: Alyona Cerfontyne, Levita D'Souza, Lefteris Patlamazoglou

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Unlike adoption and donor-assisted reproduction, misattributed paternity occurring within the context of spontaneous conception and outside of formally recognised practices of having a child remains largely an understudied phenomenon. In adulthood, to discover misattributed paternity, i.e., that the man you call your father is not related to you genetically, can have profound implications for everyone affected. Until the advent of direct-to-consumer DNA testing 20 years ago, such discoveries were relatively rare. Despite the growing number of individuals uncovering their biogenetic paternity through genetic testing, there is very limited research on misattributed paternity from the perspective of adult children affected by it. No research exists on how to support these individuals through counselling post-discovery. Framed as insider action research, this study aimed to explore the perceived psychosocial consequences of misattributed paternity discoveries and coping strategies used by individuals who discover their misattributed paternity status in adulthood. In total, 12 individuals with misattributed paternity participated in semi-structured interviews in July-August 2022. The collected data was analysed using reflexive thematic analysis. The study’s results indicate that discovering misattributed paternity in adulthood can be likened to a watershed moment forever changing the trajectory of one’s life. Psychological experiences consistent with trauma, as well as grief and loss, re-evaluation of close family relationships, reestablishment of one’s identity, as well as experiencing a profound need to belong are the key themes emerging from the analysis of psychosocial experiences. Post-discovery, individuals with misattributed paternity employ a wide range of emotional and problem-focused coping strategies, amongst which seeking connection with those who understand, searching for information on the new biogenetic family and finding new meanings to life are most prominent. The study contributes both to the academic and practical knowledge of experiences of misattributed paternity and highlights the importance of further research on the topic.

Keywords: discovery of misattributed paternity, misattributed paternity, paternal discrepancy, psychosocial consequences, coping

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Authors: Kebron Abich Asnake

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The outbreak of COVID-19 has had far-reaching socio-economic consequences globally, and Ethiopia is no exception. This abstract provides a summary of a research study on the socio-economic impact of COVID-19 in Ethiopia. The study analyzes the health impact, economic repercussions, social consequences, government response measures, and opportunities for post-crisis recovery. In terms of health impact, the research explores the spread and transmission of the virus, the capacity and response of the healthcare system, and the mortality rate, with a focus on vulnerable populations. The economic impact analysis entails investigating the contraction of the GDP, employment and income loss, disruption in key sectors such as agriculture, tourism, and manufacturing, and the specific implications for small and medium-sized enterprises (SMEs), foreign direct investment, and remittances. The social impact section looks at the disruptions in education and the digital divide, food security and nutrition challenges, increased poverty and inequality, gender-based violence, and mental health issues. The research also examines the measures taken by the Ethiopian government, including health and safety regulations, economic stimulus packages, social protection programs, and support for vulnerable populations. Furthermore, the study outlines long-term recovery prospects, social cohesion, and community resilience challenges. It highlights the need to strengthen the healthcare system and finds a balance between health and economic priorities. The research concludes by presenting recommendations for policy-makers and stakeholders, emphasizing opportunities for post-crisis recovery such as diversification of the economy, enhanced healthcare infrastructure, investment in digital infrastructure and technology, and support for domestic tourism and local industries. This research provides valuable insights into the socio-economic impact of COVID-19 in Ethiopia, offering a comprehensive analysis of the challenges faced and potential pathways towards recovery.

Keywords: impact, covid, ethiopia, health

Procedia PDF Downloads 63

Authors: Yaolin Tian, Shanxiong Chen, Fujia Zhao, Xiaoyu Lin, Hailing Xiong

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Ancient books are significant culture inheritors and their background textures convey the potential history information. However, multi-style texture recovery of ancient books has received little attention. Restricted by insufficient ancient textures and complex handling process, the generation of ancient textures confronts with new challenges. For instance, training without sufficient data usually brings about overfitting or mode collapse, so some of the outputs are prone to be fake. Recently, image generation and style transfer based on deep learning are widely applied in computer vision. Breakthroughs within the field make it possible to conduct research upon multi-style texture recovery of ancient books. Under the circumstances, we proposed a network of layout analysis and image fusion system. Firstly, we trained models by using Deep Convolution Generative against Networks (DCGAN) to synthesize multi-style ancient textures; then, we analyzed layouts based on the Position Rearrangement (PR) algorithm that we proposed to adjust the layout structure of foreground content; at last, we realized our goal by fusing rearranged foreground texts and generated background. In experiments, diversified samples such as ancient Yi, Jurchen, Seal were selected as our training sets. Then, the performances of different fine-turning models were gradually improved by adjusting DCGAN model in parameters as well as structures. In order to evaluate the results scientifically, cross entropy loss function and Fréchet Inception Distance (FID) are selected to be our assessment criteria. Eventually, we got model M8 with lowest FID score. Compared with DCGAN model proposed by Radford at el., the FID score of M8 improved by 19.26%, enhancing the quality of the synthetic images profoundly.

Keywords: deep learning, image fusion, image generation, layout analysis

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Authors: Rafika Bayu Kusumandari, Istyarini, Ispen Safrel

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Character education will be more meaningful if carried out since early childhood. This is because early childhood education is the foundation of the formation of character. This study intends to find a model of character education in early childhood based on Javanese culture. In keeping with the focus of the study, long-term goals to be achieved through this research is to find once described the development of a model of character education in early childhood Javanese culture based in Semarang are then applied across early childhood education institutions in Semarang City. The specific objective of the study is: Describe the character models and management education in early childhood Java-based culture in Semarang City. The benefits of this research are; Provide an overview of the model and describe the management of character education in early childhood Java-based culture in Semarang City. Referring to the objectives of the research program was designed with a "Research and Development", meaning that a program of research followed by development programs for improvement or refinement. To produce a prototype model of character education in early childhood Java-based culture in the city, taken systematic measures in the form of the action, reflection, evaluation and innovation by applying qualitative research methods, descriptive, development, experimentation, and evaluation. This study aims to gain in-depth description of the model of character education in early childhood Java-based culture in the city of Semarang. The reason for the use of the use of qualitative methods researcher's knowledge, no study results and empirical research specifically about the model of character education in early childhood Java-based culture in the city of Semarang. On the implementation of character education early childhood adapted to the characteristics of each school and the emphasis of each agency arrangements for early childhood education, culture-based Java. Javanese culture should be introduced early in order not to erode the cultural lost outside the entrance as the era of globalization. In addition, Java is promoting a culture of courtesy and manners are very appropriate for the character formation of children of early age.

Keywords: education character, Javanese culture, childhood, character

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Authors: Saima Akbar, Tahseen Ullah Khan

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The analysis of the climate change impact on flood frequency represents an important issue for water resource management and flood risk mitigation. This research was conducted to address the effects of climate change on flood incidents of Pakistan and find out gaps in existing policies to reducing the environmental aspects on floods and effects of global warming. The main objective of this research was to critically analyses the National Climate Change Policy (NCCP), National Disaster Management Authority (NDMA), Federal Flood Commission (FFC) and Vision 2025, as an effective policy document which is not only hitting the target of a climate resilient Pakistan but provides room for efficient and flexible policy implementation. The methodology integrates projected changes in monsoon patterns (since last 20 years and overall change in rainfall pattern since 1901 to 2015 from Pakistan Metrological Department), glacier melting, decreasing dam capacity and lacks in existing policies by using SWOT (Strength, Weakness, Opportunities, Threats) model in order to explore the relative impacts of global warming on the system performance. Results indicate the impacts of climate change are significant, but probably not large enough to justify a major effort for adapting the physical infrastructure to expected climatic conditions in Vision 2025 which is our shared destination to progress, ultimate aspiration to see Pakistan among the ten largest economies of the world by 2047– the centennial year of our independence. The conclusion of this research was to adapt sustainable measures to reduce flood impacts and make policies as neighboring countries are adapting for their sustainability.

Keywords: climatic factors, monsoon, Pakistan, sustainability

Procedia PDF Downloads 131

Authors: Syed Hammad Ali, Rijan Bhakta Kayastha, Ahuti Shrestha, Iram Bano

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The hydrology of Upper Indus basin is not recognized well due to the intricacies in the climate and geography, and the scarcity of data above 5000 meters above sea level where most of the precipitation falls in the form of snow. The main objective of this study is to measure the contributions of different components of runoff in Upper Indus basin. To achieve this goal, the Modified positive degree-day model (MPDDM) was used to simulate the runoff and investigate its components in two catchments of Upper Indus basin, Hunza and Gilgit River basins. These two catchments were selected because of their different glacier coverage, contrasting area distribution at high altitudes and significant impact on the Upper Indus River flow. The components of runoff like snow-ice melt and rainfall-base flow were identified by the model. The simulation results show that the MPDDM shows a good agreement between observed and modeled runoff of these two catchments and the effects of snow-ice are mainly reliant on the catchment characteristics and the glaciated area. For Gilgit River basin, the largest contributor to runoff is rain-base flow, whereas large contribution of snow-ice melt observed in Hunza River basin due to its large fraction of glaciated area. This research will not only contribute to the better understanding of the impacts of climate change on the hydrological response in the Upper Indus, but will also provide guidance for the development of hydropower potential, water resources management and offer a possible evaluation of future water quantity and availability in these catchments.

Keywords: future discharge projection, positive degree day, regional climate model, water resource management

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Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

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Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

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Authors: Tara Moore

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Madagascar is one of the regions of the world with the highest biodiversity, with more than 600 new species discovered in just the last decade. In parallel with its record-breaking biodiversity, Madagascar is also the tenth poorest country in the world. The resultant socio-economic pressures are leading to a highly threatened environment. In particular, deforestation is at the core of biodiversity and ecosystem loss, primarily from slash and burn agriculture and illegal rosewood tree harvesting. Effective policy response is imperative for improved conservation in Madagascar. However, these changes cannot come from the current, unstable government institutions. After a violent and politically turbulent coup in 2009, any effort to defend Madagascar's biodiversity has been eclipsed by the high corruption of government bodies. This paper presents three policy options designed for a private donor to invest in conservation in Madagascar. The first proposed policy consists of payments for ecosystem services model, which involves paying local Malagasy women to reforest nearby territories. The second option is a micro-irrigation system proposal involving relocating local Malagasy out of the threatened forest region. The final proposition is captive breeding funding for the Madagascar Fauna and Flora Group, which could then lead to new reintroductions in the threatened northeastern rainforests. In the end, all three options present feasible, impactful options for a conservation-minded major donor. Ideally, the policy change would involve a combination of all three options, as each provides necessary development and conservation re-structuring goals. Option one, payments for ecosystem services, would be the preferred choice if there were only enough funding for one project. The payments for ecosystem services project both support local populations and promotes sustainable development while reforesting the threatened Marojejy National Park. Regardless of the chosen policy solution, any support from a donor will make a huge impact if it supports both sustainable development and biodiversity conservation.

Keywords: captive breeding, cnservation policy, lemur conservation, Madagascar conservation, payments for ecosystem services

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Luksanaporn Krungkraipetch

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A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Qianhui Li, Christoph H. Bruecker

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Atherosclerotic plaques are typically found where flow separation and variations of shear stress occur. Although helical flow patterns and flow separations have been recorded in the aorta, their relation has not been clearly clarified and especially in the condition of artificial heart valve prostheses. Therefore, an experimental study is performed to investigate the hemodynamic performance of different mechanical heart valves (MHVs), i.e. the SJM Regent bileaflet mechanical heart valve (BMHV) and the Lapeyre-Triflo FURTIVA trileaflet mechanical heart valve (TMHV), in a transparent model of the human aorta under a physiological pulsatile right-hand helical flow condition. A typical systolic flow profile is applied in the pulse-duplicator to generate a physiological pulsatile flow which thereafter flows past an axial turbine blade structure to imitate the right-hand helical flow induced in the left ventricle. High-speed particle image velocimetry (PIV) measurements are used to map the flow evolution. A circular open orifice nozzle inserted in the valve plane as the reference configuration initially replaces the valve under investigation to understand the hemodynamic effects of the entered helical flow structure on the flow evolution in the aortic arch. Flow field analysis of the open orifice nozzle configuration illuminates the helical flow effectively delays the flow separation at the inner radius wall of the aortic arch. The comparison of the flow evolution for different MHVs shows that the BMHV works like a flow straightener which re-configures the helical flow pattern into three parallel jets (two side-orifice jets and the central orifice jet) while the TMHV preserves the helical flow structure and therefore prevent the flow separation at the inner radius wall of the aortic arch. Therefore the TMHV is of better hemodynamic performance and reduces the pressure loss.

Keywords: flow separation, helical aortic flow, mechanical heart valve, particle image velocimetry

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Authors: Sara S. Fouad, Omneya Messallam

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In 1818, a seventy-five kilometer long canal was dug (called the Mahmoudiyah canal) connecting between Alexandria city in Egypt and the western branch of the Nile. It was a productive resource and vital to its environment, context, transportation, and recreation. It played a significant role in people’s lives and Alexandria city’s shape. The canal, which was the main vein of goods’ transporting from Alexandria’s seaport to the different parts of Egypt, was still in use today as a major source of clear water in the city. But nowadays, Mahmoudiyah canal is converting into ‘dead waterway’. The canal became sources of pollution as a result of solid and industrial waste thus causing many diseases, destroying communities and biodiversity, with urban invasion, the loss of community aesthetic value and healthy environment. Therefore, this paper aims to propose an urban strategy, as a solution to revive the forgotten canal, through recreating a cultural promenade on its shore. The main aim of this research is to formulate decent quality of life, unpolluted space, an area gathering the city space for nature, tourism and investments. As a case study, this paper investigates Mahmoudiyah canal through urban and ecological analyses, aiming to design an urban strategy for reviving it by creating a cultural promenade enriched with public spaces and green areas, which can most probably enhance the quality of life, city re-living and development. Community participation is also considered as vital and intrinsic implementation stage. The empirical research involved using several data assembly methods such as interviews, mental mapping, structural observations and questionnaires. The paper ends with a set of conclusions leading to proposals for the Mahmoudiyah canal revitalization considering the complex challenges and processes of sustainable regeneration focusing on city’s rehabilitation and lost identity.

Keywords: Mahmoudiyah canal, community aesthetic value, city re-living, cultural promenade

Procedia PDF Downloads 115

Authors: F. O. Danquah, F. Frimpong, E. Owusu Danquah, T. Frimpong, J. Adu, S. K. Amposah, P. Amankwaa-Yeboah, N. E. Amengor

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In the face of global concerns such as population increase, climate change, and limited natural resources, sustainable agriculture practices are critical for ensuring food security and environmental stewardship. The study was conducted in the Forest zones of Ghana during the major and minor seasons of 2023 cropping seasons to evaluate maize yield productivity improvement and profitability of integrating Cajanus cajan (pigeonpea) into a maize production system described as a pigeonpea-maize cropping system. This is towards an integrated soil fertility management (ISFM) with a legume shrub pigeonpea for sustainable maize production while improving smallholder farmers' resilience to climate change. A split-plot design with maize-pigeonpea (Pigeonpea-Maize intercrop – MPP and No pigeonpea/ Sole maize – NPP) and inorganic fertilizer rate (250 kg/ha of 15-15-15 N-P2O5-K2O + 250 kg/ha Sulphate of Ammonia (SoA) – Full rate (FR), 125 kg/ha of 15-15-15 N-P2O5-K2O + 125 kg/ha Sulphate of Ammonia (SoA) – Half rate (HR) and no inorganic fertilizer (NF) as control) was used as the main plot and subplot treatments respectively. The results indicated a significant interaction of the pigeonpea-maize cropping system and inorganic fertilizer rate on the growth and yield of the maize with better and similar maize productivity when HR and FR were used with pigeonpea biomass. Thus, the integration of pigeonpea and its biomass would result in the reduction of recommended fertiliser rate to half. This would improve farmers’ income and profitability for sustainable maize production in the face of climate change.

Keywords: agroforestry tree, climate change, integrated soil fertility management, resource use efficiency

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Authors: Kamyar Maleki Bagherabadi, Torstein Aarseth Bø, Truls Flatberg, Olve Mo

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Hydrogen fuel cells and batteries are one of the promising solutions aligned with carbon emission reduction goals for the marine sector. However, the higher installation and operation costs of hydrogen-based systems compared to conventional diesel gensets raise questions about the appropriate hydrogen tank size, energy, and fuel consumption estimations. Ship designers need methodologies and tools to calculate energy and fuel consumption for different component sizes to facilitate decision-making regarding feasibility and performance for retrofits and design cases. The aim of this work is to compare three alternative modeling approaches for the estimation of energy and fuel consumption with various hydrogen tank sizes, battery capacities, and load-sharing strategies. A fishery vessel is selected as an example, using logged load demand data over a year of operations. The modeled power system consists of a PEM fuel cell, a diesel genset, and a battery. The methodologies used are: first, an energy-based model; second, considering load variations during the time domain with a rule-based Power Management System (PMS); and third, a load variations model and dynamic PMS strategy based on optimization with perfect foresight. The errors and potentials of the methods are discussed, and design sensitivity studies for this case are conducted. The results show that the energy-based method can estimate fuel and energy consumption with acceptable accuracy. However, models that consider time variation of the load provide more realistic estimations of energy and fuel consumption regarding hydrogen tank and battery size, still within low computational time.

Keywords: fuel cell, battery, hydrogen, hybrid power system, power management system

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Authors: Timine Suoware, Sylvester Edelugo, Charles Amgbari

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Natural fibre composites (NFC) are becoming very attractive especially for automotive interior and non-structural building applications because they are biodegradable, low cost, lightweight and environmentally friendly. NFC are known to release high combustible products during exposure to heat atmosphere and this behaviour has raised concerns to end users. To improve on their fire response, flame retardants (FR) such as aluminium tri-hydroxide (ATH) and ammonium polyphosphate (APP) are incorporated during processing to delay the start and spread of fire. In this paper, APP was modified with Gum Arabic powder (GAP) and synergized with carbon black (CB) to form new FR species. Four FR species at 0, 12, 15 and 18% loading ratio were added to oil palm fibre polyester composite (OPFC) panels as follows; OPFC12%APP-GAP, OPFC15%APP-GAP/CB, OPFC18%ATH/APP-GAP and OPFC18%ATH/APPGAP/CB. The panels were produced using hand lay-up compression moulding and cured at room temperature. Specimens were cut from the panels and these were tested for ignition time (Tig), peak heat released rate (HRRp), average heat release rate (HRRavg), peak mass loss rate (MLRp), residual mass (Rm) and average smoke production rate (SPRavg) using cone calorimeter apparatus as well as the available flame energy (ɸ) in driving the flame using radiant panel flame spread apparatus. From the ignitability data obtained at 50 kW/m2 heat flux (HF), it shows that the hybrid FR modified with APP that is OPFC18%ATH/APP-GAP exhibited superior flame retardancy and the improvement was based on comparison with those without FR which stood at Tig = 20 s, HRRp = 86.6 kW/m2, HRRavg = 55.8 kW/m2, MLRp =0.131 g/s, Rm = 54.6% and SPRavg = 0.05 m2/s representing respectively 17.6%, 67.4%, 62.8%, 50.9%, 565% and 62.5% improvements less than those without FR (OPFC0%). In terms of flame spread, the least flame energy (ɸ) of 0.49 kW2/s3 for OPFC18%ATH/APP-GAP caused early flame regression. This was less than 39.6 kW2/s3 compared to those without FR (OPFC0%). It can be concluded that hybrid FR modified with APP could be useful in the automotive and building industries to delay the start and spread of fire.

Keywords: flame retardant, flame regression, oil palm fibre, composite panel

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Authors: Khanday Pervaiz Ahmad

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It was in 19th century when the Indian educated class started to reform their socio-religious set up as an imperative to respond to the challenges put forward by the colonial empire. The colonial discourse on India from the very beginning was gendered, as the colonized society was feminized and its ‘effeminate’ character, as opposed to ‘colonial masculinity’ was held to be a justification for its loss of independence. The ‘women health figure’ is prominently in these gender discourses. The women’s health received a much place in the colonial discourse. Lack of health consciousness, illiteracy, and belief in myths, rituals and superstitions were deemed the main factors taken as an indicator of miserable condition of Indian women’s health. As the low position of women caused shame to the natives, reforming the condition of women, its health occupied a major place in their intellectual as well as activist engagements. Magazines (journals) for women began to appear in various Indian languages in the mid to late 19th century with Bengal leading the front. These sources (Magazines) like Harm, Tehzib un Niswan, Saheli, Khatoon etc. are essential for the study of the emergence of an ideology of respectable domesticity in Indian Muslim upper middle class. Similarly for the study of development of Women’s health consciousness, women’s magazines are very essential. These earliest women Urdu magazines were first started by men, and then followed by the women’s own magazines. Various health issues, like pregnancy, child-rearing, menstruation, midwives training, Pardah, and health etc. were discussed at a time when it was impossible to discuss them in public sphere. These women magazines were brave pioneers, expanding the frontiers of women’s roles, and consciousness at a time when those frontiers were severely limited. This paper will try to focus on how women responded to the question of colonial discourse about their bodies. How health consciousness developed among Indian Muslim women and in what way it contributed in the development of feminist consciousness in South Asian Muslim Women community.

Keywords: Ashraf class, khatoon, haram women, feminism

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba, Marek Jan Kuzniewski

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Introduction: Vitamin D3 has a proven pleiotropic effect, not only responsible for calcium and phosphate management, but also influencing normal functioning of the whole body. Aim: Evaluation of vitamin D3 resources and its effect on a nutritional status, obesity type and glomerular filtration in kidney transplant recipients. Methods: Group of 152 (81 women and 71 men, average age 47.8 ± 11.6 years) patients with a functioning renal transplant their body composition was assessed using the bioimpendance method (BIA) and anthropometric measurements more than 3 months after the transplant. The nutritional status and the obesity type were determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). 25- Hydroxyvitamin D3 (25 (OH)D3) was determined, together with its correlation with the obesity type and the glomerular filtration rate (eGFR) calculated with the MDRD formula. Results: The mean 25 (OH)D3 level was 20.4 ng/ml. 30ng/ml was considered as a minimum correct level 22,7% of patients from the study group were classified to be a correct body weight, 56,7% of participants had an android type and 20,6% had a gynoid type. Significant correlation was observed between 25 (OH)D3 deficiency and abdominal obesity (p < 0.005) in patients. Furthermore, a statistically significant relationship was demonstrated between the 25 (OH)D3 levels and eGFR in patients after a kidney transplant. Patients with an android body type had lower eGFR versus those with the gynoid body type (p=0.004). Conclusions: Correct diet in patients after a kidney transplant determines minimum recommended serum levels of vitamin D3. Excessive fatty tissue, low levels of 25 (OH)D3), may be a predictor for android obesity and renal injury; therefore, correct diet and pharmacological management together with physical activities adapted to the physical fitness level of a patient are necessary.

Keywords: kidney transplantation, glomerular filtration rate, obesity, vitamin D3

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Authors: Orlando Ketebu

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Ogbono seed is the seed obtained from African bush mango (Irvingia gabonenesis) and bitter bush mango (Irvingia wombolu). Irvingia gabonenesis is known for its sweet edible pulp while Irvingia wombolu has a bitter pulp. Their seed powder is used in cooking soup known as ogbono soup in Nigeria and in West Africa. The powder thickens when cooked and researches have shown that it has medicinal uses such as lowering cholesterol; aiding weight loss and helps in improving diabetes control. The nutritional composition of the seeds indicated that Irvingia gabonenesis contains 8.60% protein, 13.8% carbohydrate, 2.0% moisture, 1.5% crude fiber, 16.4% ash, and Irvingia wombolu contains 7.38% protein, 25.75% carbohydrate, 11.7% moisture, 0.84% crude fiber, 2.50% ash. Solvent extraction of these seeds has shown that the seed of the two species are oil seeds with approximately 70 % and 52 % for Irvingia gabonenesis and Irvingia wombolu respectively. One major setback using ogbono seed powder in cooking soup is identifying the specie of ogbono seed powder that thickens most within the same cooking condition and how temperature affects the thickness of ogbono seed powder which determines its viscosity and in turn affects the quality of the soup and its nutrients. This research work monitored how the viscosity of ogbono species after being sun dried for one week changes with temperature. The result showed that heating 20 grams of powdered Irvingia gabonenesis and Irvingia wombolu at 30 OC, 45 OC, 55 OC, 65 OC, 75 OC, 85 OC and 95OC respectively in 200 ml beaker mixed with 100 ml of water, the viscosity of both species decreases with increase temperature with Irvingia wombolu having higher average viscosity in Pascal seconds (Pa.s) of 1.059, 1.042, 0.961, 0.778, 0.684, 0.675, and 0.495 at 30 OC, 45 OC, 55 OC, 65 OC, 75 OC, 85 OC and 95 OC respectively compared to Irvingia gabonenesis with result 0.982, 0.920, 0.720, 0.646, 0.597 and 0.446 at 30 OC, 45 OC, 55 OC, 65 OC, 75 OC, 85 OC and 95 OC respectively. Also from the experiment carried out it was found out that the viscosity of both species decreases with ageing of the seeds and the quantity of ogbono seed powder used and amount of water added also affected the viscosity of both species. In conclusion, it was observed that under the same cooking conditions (temperature range, quantity of water added, time and quantity of ogbono seed powder used), Irvingia wombolu had higher viscosity which is a measure of its thickness and quality of nutrients compared to Irvingia gabonenesis and the viscosity of both species decreases with increasing temperature.

Keywords: ogbono seed powder, temperature, viscosity , soup

Procedia PDF Downloads 180

Authors: Jie Ren, Siyao Guo

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Laden with phosphates at a low pH value, sewage wastewater aggressive environments constitute a great threat to concrete-based pipes which is made of alkaline cementitious materials such as ordinary Portland cement (OPC). As a promising alternative for OPC-based binders, alkali-activated slag/fly ash (AASF) cementitious binders are generally believed to gain similar or better properties compared to OPC-based counterparts, especially durability. However, there is limited research on the performance of AASF binders in phosphoric acid solution. Moreover, the behavior of AASF binders composited with epoxy resin/TiO₂ when exposed to acidic media has been rarely explored. In this study, the performance of AASF paste with the precursor slag:fly ash (50:50 in mass ratio) enhanced with epoxy resin/TiO₂ composite in phosphoric acid solution (pH = 3.0-4.0) was investigated. The exposure towards acid attack lasted for 90 days. The same AASF mixture without resin/TiO₂ composite was used as a reference. The compressive strength and porous-related properties prior to acidic immersion were tested. The mass variations and degradation depth of the two mixtures of binders were also monitored which is based on phenolphthalein-videomicroscope method. The results show that the binder with epoxy resin/TiO₂ addition gained a higher compressive strength and lower water absorption than the reference. In addition, it also displayed a higher resistance towards acid attack indicated by a less mass loss and less degradation depth compared to the control sample. This improvement can be attributed to a dense microstructure evidenced by the higher compressive strength and related porous structures. It can be concluded that the microstructure can be improved by adding epoxy resin/TiO₂ composite in order to enhance the resistance of AASF binder towards acid attacks.

Keywords: alkali-activated paste, epoxy resin/TiO₂, composites, mechanical properties, phosphoric acid

Procedia PDF Downloads 107

Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

Procedia PDF Downloads 184

Authors: H. Hakim, C. Kibert, C. Fabre, S. Monadizadeh

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Construction industry is an industry saddled with chronic problems of high waste generation. Waste management that is to ensure materials are utilized in an efficient manner would make a major contribution to mitigating the negative environmental impacts of construction waste including finite resources depletion and growing occupied landfill areas to name a few. Furthermore, ‘material resource efficiency’ has been found an economically smart approach specially when considered during the design phase. One effective strategy is to utilizing off-site construction process which includes a series of prefabricated systems such as mobile, modular, and HUD construction (Department of Housing and Urban Development manufactured buildings). These types of buildings are by nature material and resource-efficient. Despite conventional construction that is exposed to adverse weather conditions, manufactured construction production line is capable of creating repetitive units in a factory controlled environment. A factory can have several parallel projects underway with a high speed and in a timely manner which simplifies the storage of excess materials and re-allocating to the next projects. The literature reports that prefabricated construction significantly helps reduce errors, site theft, rework, and delayed problems and can ultimately lead to a considerable waste reduction. However, there is not sufficient data to quantify this reduction when it comes to a regular modular house in the U.S. Therefore, this manuscript aims to provide an analysis of waste originated from a manufactured factory trend. The analysis was made possible with several visits and data collection of Homes of Merits, a Florida Manufactured and Modular Homebuilder. The results quantify and verify a noticeable construction waste reduction.

Keywords: construction waste, modular construction, prefabricated buildings, waste management

Procedia PDF Downloads 252

Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

Procedia PDF Downloads 188

Authors: Yusuf Garba Baba

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The construction industry and housing subsector are fraught with risks that have the potential of negatively impacting on the achievement of project objectives. The success or otherwise of most construction projects depends to large extent on how well these risks have been managed. The recent paradigm shift by the subsector to use of formal risk management approach in contrast to hitherto developed rules of thumb means that risks must not only be identified but also properly assessed and responded to in a systematic manner. The study focused on identifying risks associated with housing development projects and prioritisation assessment of the identified risks in order to provide basis for informed decision. The study used a three-step identification framework: review of literature for similar projects, expert consultation and questionnaire based survey to identify potential risk factors. Delphi survey method was employed in carrying out the relative prioritization assessment of the risks factors using computer-based Analytical Hierarchical Process (AHP) software. The results show that 19 out of the 50 risks significantly impact on housing development projects. The study concludes that although significant numbers of risk factors have been identified as having relevance and impacting to housing construction projects, economic risk group and, in particular, ‘changes in demand for houses’ is prioritised by most developers as posing a threat to the achievement of their housing development objectives. Unless these risks are carefully managed, their effects will continue to impede success in these projects. The study recommends the adoption and use of the combination of multi-technique identification framework and AHP prioritization assessment methodology as a suitable model for the assessment of risks in housing development projects.

Keywords: risk management, risk identification, risk analysis, analytic hierarchical process

Procedia PDF Downloads 102

Authors: Chethika Gunasiri Wadumestrige Dona, Geetha Mohan, Kensuke Fukushi

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Solid waste in urban areas, especially from organic materials like garden waste, food, and degradable sources, can create health and environmental problems if not managed properly. Urban agriculture has emerged as a potential solution in developing countries to mitigate these issues. It offers the possibility of low-carbon economies and knowledge and innovation dissemination. Domestic composting is a significant aspect of urban agriculture, and its success relies on the attitudes of those who practice it. This study examines the perspectives of 402 urban farmers in the Colombo District, Sri Lanka, regarding domestic compost production. It aims to identify the factors that influence these perspectives. The research found that urban farmers are willing to participate in domestic composting because they believe that it facilitates effective recycling of organic waste within their households. The study used an ordinal regression model to determine the factors that shape farmers' perspectives. Age, family size, and crop preferences are significant determinants of the adoption of domestic composting practices among urban farmers in the Colombo District. These findings highlight the importance of understanding and addressing farmers' attitudes in designing effective waste management strategies. In addition, the study also emphasizes the need for tailored interventions that align with farmers' beliefs and preferences to enhance the adoption and implementation of domestic composting practices in urban areas. The insights gained from this study contribute to the academic discourse and offer practical guidance for policymakers and urban planners seeking to promote sustainable waste management practices and support the adoption of urban agriculture in the broader context of urban development.

Keywords: urban agriculture, domestic composting, farmers` perspectives, sustainable urban development

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

Procedia PDF Downloads 410

Authors: Nadeem Munawar, David Galbraith, Tariq Mahmood

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Rodenticides are often included as part of an integrated pest management approach for managing rodent species since they are relatively quick and inexpensive to apply. The current field study was conducted to evaluate the effectiveness of formulated baits of zinc phosphide (2%) and the second generation anticoagulant brodifacoum (0.005%) against field rats inhabiting a wheat-groundnut cropping system. Burrow baiting was initiated at the early flowering stages of the respective crops, and continued through three growth stages (tillering / peg formation, flowering, and maturity). Three treatments were done at equal time intervals, with the final baiting being about 2 weeks before harvest. Treatment efficacy of the trials was assessed through counts of active rodent burrows before and after treatments at the three growth stages of these crops. The results indicated variable degrees of reduction in burrow activities following the three bait applications. The reductions in rodent activity in wheat were: 88.8% (at tillering), 92%, (at flowering/grain formation), and 95.5% (at maturity). In groundnut, the rodent activities were reduced by 91.8%, 93.5% and 95.8% at sowing, peg formation, and maturity stages, respectively. The estimated mortality at all three growth stages of both wheat and groundnut ranged between 60-85%. We recommend that a field efficacy study should be conducted with zinc phosphide and brodifacoum bait formulations to determine their field performance in the reduction of agricultural damage by rodent pest species. It is a promising alternative approach for use of the most potent second-generation anticoagulant (brodifacoum) in resistance management, particularly with respect to reducing environmental risks and secondary poisoning.

Keywords: brodifacoum, burrow baiting, second-generation anticoagulant, synergistic effect

Procedia PDF Downloads 109

Authors: Merav Meiron-Goren, Orna Braun-Lewensohn, Tal Litvak-Hirsh

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In recent years, there has been an increasing tendency towards separation and divorce in relationships. Nevertheless, many couples in a first marriage do not anticipate this as a probable possibility and do not make any preparation for it. Same sex couples establishing a family encounter a much more complicated situation than do heterosexual couples. Although there is a trend towards legal recognition of same sex marriage, many countries, including Israel, do not recognize it. The absence of legal recognition or the existence of partial recognition creates complexity for these couples. They have to fight for their right to establish a family, like the recognition of the biological child of a woman, as a child of her woman spouse too, or the option of surrogacy for a male couple who want children, and more. The lack of legal recognition is burden on the lives of these couples. In the absence of clear norms regarding the conduct of the family unit, the couples must define for themselves the family structure, and deal with everyday dilemmas that lack institutional solutions. This may increase the friction between the two couple members, and it is one of the factors that make it difficult for them to maintain the relationship. This complexity exists, perhaps even more so, in separation. The end of relationship is often accompanied by a deep crisis, causing pain and stress. In most cases, there are also other conflicts that must be settled. These are more complicated when rights are in doubt or do not exist at all. Complex issues for separating same sex couples may include matters of property, recognition of parenthood, and care and support for the children. The significance of the study is based on the fact that same sex relationships are becoming more and more widespread, and are an integral part of the society. Even so, there is still an absence of research focusing on such relationships and their ending. The objective of the study is to research the perceptions of same sex couples regarding the possibility of separation, preparing for it, conflict management and resolving disputes through the separation process. It is also important to understand the point of view of couples that have gone through separation, how they coped with the emotional and practical difficulties involved in the separation process. The doctoral research will use a qualitative research method in a phenomenological approach, based on semi-structured in-depth interviews. The interviewees will be divided into three groups- at the beginning of a relationship, during the separation crisis and after separation, with a time perspective, with about 10 couples from each group. The main theoretical model serving as the basis of the study will be the Lazarus and Folkman theory of coping with stress. This model deals with the coping process, including cognitive appraisal of an experience as stressful, appraisal of the coping resources, and using strategies of coping. The strategies are divided into two main groups, emotion-focused forms of coping and problem-focused forms of coping.

Keywords: conflict management, coping, legal recognition, same-sex relationship, separation

Procedia PDF Downloads 129

Authors: Marcel Schneider, Nils Nießen

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Microscopic simulation programs enable the description of the two processes of railway operation and the previous timetabling. Occupation conflicts are often solved based on defined train priorities on both process levels. These conflict resolutions produce knock-on delays for the involved trains. The sum of knock-on delays is commonly used to evaluate the quality of railway operations. It is either compared to an acceptable level-of-service or the delays are evaluated economically by linearly monetary functions. It is impossible to properly evaluate dispatching decisions without a well-founded objective function. This paper presents a new approach for evaluation of dispatching decisions. It uses models of choice of transport and considers the behaviour of the end-costumers. These models evaluate the knock-on delays in more detail than linearly monetary functions and consider other competing modes of transport. The new approach pursues the coupling of a microscopic model of railway operation with the macroscopic model of choice of transport. First it will be implemented for the railway operations process, but it can also be used for timetabling. The evaluation considers the possibility to change over to other transport modes by the end-costumers. The new approach first looks at the rail-mounted and road transport, but it can also be extended to air transport. The split of the end-costumers is described by the modal-split. The reactions by the end-costumers have an effect on the revenues of the railway undertakings. Various travel purposes has different pavement reserves and tolerances towards delays. Longer journey times affect besides revenue changes also additional costs. The costs depend either on time or track and arise from circulation of workers and vehicles. Only the variable values are summarised in the contribution margin, which is the base for the monetary evaluation of the delays. The contribution margin is calculated for different resolution decisions of the same conflict. The conflict resolution is improved until the monetary loss becomes minimised. The iterative process therefore determines an optimum conflict resolution by observing the change of the contribution margin. Furthermore, a monetary value of each dispatching decision can also be determined.

Keywords: choice of transport, knock-on delays, monetary evaluation, railway operations

Procedia PDF Downloads 314

Authors: Raya Kathreen T. Fuentes, Christian Owen P. Domingo, Kaisha V. Durana, Kristine Chelsea Shynne M. Evangelista, Nicole A. Feliciano, Kathleen Patricia Q. Ferido, Christianna Joy J. Ferrer

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Diabetes Mellitus (DM) is a global public health concern. The foot ulcer is one of the most serious and costly complications of DM. Among the components of diabetes self-management (DSM), foot self-care was found to be one of the best preventive measures for foot ulcers yet is seldom performed. Thus, the purpose of this study is to determine how adequate foot self-care practices (FSP) are among Filipino adults with DM with the following objectives: 1) determine their DSM, 2) describe their FSP, 3) determine the relationship between FSP and DSM, and 4) determine the relationship of FSP to sociodemographic characteristics, disease-related characteristics, social support, and knowledge. A descriptive correlational design was utilized. 114 respondents aged 19-65 were selected through purposive sampling from diabetes clinics. A self-administered questionnaire regarding FSP, DSM, sociodemographic and disease-related characteristics, social support, and knowledge on diabetes were used. Pearson's correlation was utilized to determine the relationship between FSP and DSM while simple linear regression was used to determine the relationship of FSP to the factors aforementioned. Results showed that majority of the respondents have desirable DSM but inadequate FSP. FSP and DSM were shown to be positively correlated but not statistically significant (p = 0.8). Disparity among the two suggests that there is less emphasis on foot self-care compared to other components of DSM. Findings further revealed that patients diagnosed with DM for < 5 years demonstrated more adequate FSP compared to patients diagnosed for > 5 years which may suggest that newly diagnosed patients are more receptive to new information about DSM. Health education on DSM should place more emphasis on FSP. Reiteration of health education and continuous motivation should be done to all DM patients, not just to newly diagnosed patients, to improve compliance to FSP and enhance patient empowerment regarding self-care.

Keywords: diabetes mellitus, diabetes self-management, foot self-care practices, foot ulcer

Procedia PDF Downloads 182

Authors: Luciano Tarantino, Emanuele Balzano, Aurelio Nasto

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S.R. 53 years. January 2009: HCV-related cirrhosis, Child-Pugh A5 class, EGDS no aesophageal Varices. No important comorbidities. Treated with PEG-IFN+Ribavirin (march-november 2009) with subsequent sustained virologic response. HCVRNA absent overtime. October 2016 :CT detected small HCC nodule in the VIII segment (diam.=12 mm). Treated with US guided RF-ablation. November 2016 CT: complete necrosis. Unfortunately, the patient dropped out US and CT follow-up controls.September 2018: asthenia and weight loss. CT showed a large tumor infiltrating V-VII-VI segments and complete PVTT of right portal vein and its branches . Surgical Consultation excluded indication to Liver resection and OLT . 23 october 2018: ECT of a large peri-hilar area of the tumor including the PVTT. 1 and 3 months post-treatment CT showed complete necrosis and retraction of the thrombus and residual viable tumor in the peripheral portion of the right lobe . Therefor, the patient was reevaluated for OLT and considered eligible in waiting list . March 2019: CT showed no perihilar or portal vein recurrence and distant progression in the right lobe . March 2019 : Trans-arterial-Radio-therapy (TARE) of the right lobe. Post-treatment CT demonstrated no perihilar or portal vein recurrence and extensive necrosis of the residual tumor . December 2019: CT demonstrated several recurrences of HCC infiltrating the VI and VII segment . Howewer no recurrence was observed at hepatic hilum and in portal vessels . Therefore, on February 2020 the patient received OLT. At 44 months follow-up, no complication or recurrence or liver disfunction have been observed.

Keywords: hepatocellular carcinoma, portal vein tumor thrombosis, interventional ultrasound, liver tumor ablation, liver transplantation

Procedia PDF Downloads 52