Search results for: roman history
2114 Recurrent Wheezing and Associated Factors among 6-Year-Old Children in Adama Comprehensive Specialized Hospital Medical College
Authors: Samrawit Tamrat Gebretsadik
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Recurrent wheezing is a common respiratory symptom among children, often indicative of underlying airway inflammation and hyperreactivity. Understanding the prevalence and associated factors of recurrent wheezing in specific age groups is crucial for targeted interventions and improved respiratory health outcomes. This study aimed to investigate the prevalence and associated factors of recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College in Ethiopia. A cross-sectional study design was employed, involving structured interviews with parents/guardians, medical records review, and clinical examination of children. Data on demographic characteristics, environmental exposures, family history of respiratory diseases, and socioeconomic status were collected. Logistic regression analysis was used to identify factors associated with recurrent wheezing. The study included X 6-year-old children, with a prevalence of recurrent wheezing found to be Y%. Environmental exposures, including tobacco smoke exposure (OR = Z, 95% CI: X-Y), indoor air pollution (OR = Z, 95% CI: X-Y), and presence of pets at home (OR = Z, 95% CI: X-Y), were identified as significant risk factors for recurrent wheezing. Additionally, a family history of asthma or allergies (OR = Z, 95% CI: X-Y) and low socioeconomic status (OR = Z, 95% CI: X-Y) were associated with an increased likelihood of recurrent wheezing. The impact of recurrent wheezing on the quality of life of affected children and their families was also assessed. Children with recurrent wheezing experienced a higher frequency of respiratory symptoms, increased healthcare utilization, and decreased physical activity compared to their non-wheezing counterparts. In conclusion, recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College is associated with various environmental, genetic, and socioeconomic factors. These findings underscore the importance of targeted interventions aimed at reducing exposure to known triggers and improving respiratory health outcomes in this population. Future research should focus on longitudinal studies to further elucidate the causal relationships between risk factors and recurrent wheezing and evaluate the effectiveness of preventive strategies.Keywords: wheezing, inflammation, respiratory, crucial
Procedia PDF Downloads 532113 Social Media and Political Mobilization in Nigeria: A Study in E-Participation
Authors: Peter Amobi Chiamogu
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Communication has subsisted as the basis for mass mobilization and political education through history with the media as a generic concept. Revolutions in ICTs have occasioned a limitless environment for the dissemination of information and ideas especially with the use of a seemingly pervasive access, penetration and use of the internet which has engendered a connected society. This study seeks to analyze the prospects and challenges for the adaptation of social media for free election and how this process can enhance public policy making, implementation and evaluation in a developing state.Keywords: social media, e-participation, political mobilization, public policy, electioneering
Procedia PDF Downloads 3522112 The Concept of Birthday: A Theoretical, Historical, and Social Overview, in Judaism and Other Cultures
Authors: Orly Redlich
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In the age of social distance, which has been added to an individual and competitive worldview, it has become important to find a way to promote closeness and personal touch. The sense of social belonging and the existence of positive interaction with others have recently become a considerable necessity. Therefore, this theoretical paper will review one of the familiar and common concepts among different cultures around the world – birthday. This paper has a theoretical contribution that deepens the understanding of the birthday concept. Birthday rituals are historical and universal events, which noted since the prehistoric eras. In ancient history, birthday rituals were solely reserved for kings and nobility members, but over the years, birthday celebrations have evolved into a worldwide tradition. Some of the familiar birthday customs and symbols are currently common among most cultures, while some cultures have adopted for themselves unique birthday customs, which characterized their values and traditions. The birthday concept has a unique significance in Judaism as well, historically, religiously, and socially: It is considered as a lucky day and a private holiday for the celebrant. Therefore, the present paper reviews diverse birthday customs around the world in different cultures, including Judaism, and marks important birthdays throughout history. The paper also describes how the concept of birthday appears over the years in songs, novels, and art, and presents quotes from distinguished sages. The theoretical review suggests that birthday has a special meaning as a time-mark in the cycle of life, and as a socialization means in human development. Moreover, the birthday serves as a symbol of belonging and group cohesiveness, a day in which the celebrant's sense of belonging and sense of importance are strengthened and nurtured. Thus, the reappearance of these elements in a family or group interaction during the birthday ceremony allows the celebrant to absorb positive impressions about himself. In view of the extensive theoretical review, it seems that the unique importance of birthdays can serve as the foundation for intervention programs that may affect the participants’ sense of belonging and empowerment. In the group aspect, perhaps it can also yield therapeutic factors within a group. Concrete recommendations are presented at the end of the paper.Keywords: birthday, universal events, positive interaction, group cohesiveness, rituals
Procedia PDF Downloads 1412111 Literature Review of Rare Synchronous Tumours
Authors: Diwei Lin, Amanda Tan, Rajinder Singh-Rai
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We present the first reported case of a concomitant Leydig cell tumor (LCT) and paratesticular leiomyoma in an adult male with a known history of bilateral cryptorchidism. An 80-year-old male presented with a 2-month history of a left testicular lump associated with mild discomfort and a gradual increase in size on a background of bilateral cryptorchidism requiring multiple orchidopexy procedures as a child. Ultrasound confirmed a lesion suspicious for malignancy and he proceeded to a left radical orchidectomy. Histopathological assessment of the left testis revealed a concomitant testicular LCT with malignant features and paratesticular leiomyoma. Leydig cell tumors (LCTs) are the most common pure testicular sex cord-stromal tumors, accounting for up to 3% of all testicular tumors. They can occur at almost any age, but are noted to have a bi-modal distribution, with a peak incidence at 6 to 10 and at 20 to 50 years of age. LCT’s are often hormonally active and can lead to feminizing or virilizing syndromes. LCT’s are usually regarded as benign but can rarely exhibit malignant traits. Paratesticular tumours are uncommon and their reported prevalence varies between 3% and 16%. They occur in a complex anatomical area which includes the contents of the spermatic cord, testicular tunics, epididymis and vestigial remnants. Up to 90% of paratesticular tumours are believed to originate from the spermatic cord, though it is often difficult to definitively ascertain the exact site of origin. Although any type of soft-tissue neoplasm can be found in the paratesticular region, the most common benign tumors reported are lipomas of the spermatic cord, adenomatoid tumours of the epididymis and leiomyomas of the testis. Genetic studies have identified potential mutations that could potentially cause LCTs, but there are no known associations between concomitant LCTs and paratesticular tumors. The presence of cryptorchidism in adults with both LCTs and paratesticular neoplasms individually has been previously reported and it appears intuitive that cryptorchidism is likely to be associated with the concomitant presentation in this case report. This report represents the first documented case in the literature of a unilateral concomitant LCT and paratesticular leiomyoma on a background of bilateral cryptorchidism.Keywords: testicular cancer, leydig cell tumour, leiomyoma, paratesticular neoplasms
Procedia PDF Downloads 3612110 Rabih Alameddine's Appropriation of Shakespeare's The Tempest
Authors: Yousef Abu Amrieh
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This paper explores how Arab American novelist Rabih Alameddine's recent novel The Angel of History (2016) appropriates certain motifs, tropes, and themes from Shakespeare's The Tempest. In particular, Alameddine's novel re-tells the story of Caliban and his mother from the perspective of a Yemeni bastard whose mis/fortunes take him to the US shores in the eighties of the previous century. The novel, specifically, re-writes the scene in which Caliban is gazed at by European travelers like Stephano and Trinculo whose first reaction to seeing him is to consider how to sell him or give him as a gift when they safely return to Europe. The novel contests Shakespeare's representation of Caliban as 'marketable' through depicting his daily experiences in modern day America.Keywords: appropriation, Alameddine, Shakespeare, The Tempest
Procedia PDF Downloads 1702109 Shedding Light on the Black Box: Explaining Deep Neural Network Prediction of Clinical Outcome
Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler
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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model
Procedia PDF Downloads 1532108 Study on the Model Predicting Post-Construction Settlement of Soft Ground
Authors: Pingshan Chen, Zhiliang Dong
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In order to estimate the post-construction settlement more objectively, the power-polynomial model is proposed, which can reflect the trend of settlement development based on the observed settlement data. It was demonstrated by an actual case history of an embankment, and during the prediction. Compared with the other three prediction models, the power-polynomial model can estimate the post-construction settlement more accurately with more simple calculation.Keywords: prediction, model, post-construction settlement, soft ground
Procedia PDF Downloads 4252107 Observations on Cultural Alternative and Environmental Conservation: Populations "Delayed" and Excluded from Health and Public Hygiene Policies in Mexico (1890-1930)
Authors: Marcela Davalos Lopez
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The history of the circulation of hygienic knowledge and the consolidation of public health in Latin American cities towards the end of the 19th century is well known. Among them, Mexico City was inserted in international politics, strengthened institutions, medical knowledge, applied parameters of modernity and built sanitary engineering works. Despite the power that this hygienist system achieved, its scope was relative: it cannot be generalized to all cities. From a comparative and contextual analysis, it will be shown that conclusions derived from modern urban historiography present, from our contemporary observations, fractures. Between 1890 and 1930, the small cities and areas surrounding the Mexican capital adapted in their own way the international and federal public health regulations. This will be shown for neighborhoods located around Mexico City and in a medium city, close to the Mexican capital (about 80 km), called Cuernavaca. While the inhabitants of the neighborhoods kept awaiting the evolutionary process and the forms that public hygiene policies were taking (because they were witnesses and affected in their territories), in Cuernavaca, the dictates came as an echo. While the capital was drained, large roads were opened, roundabouts were erected, residents were expelled, and drains, sewers, drinking water pipes, etc., were built; Cuernavaca was sheltered in other times and practices. What was this due to? Undoubtedly, the time and energy that it took politicians and the group of "scientists" to carry out these enormous works in the Mexican capital took them away from addressing the issue in remote villages. It was not until the 20th century that the federal hygiene policy began to be strengthened. Despite this, there are other factors that emphasize the particularities of each site. I would like to draw attention here to the different receptions that each town prepared on public hygiene. We will see that Cuernavaca responded to its own semi-rural culture, history, orography and functions, prolonging for much longer, for example, the use of its deep ravines as sewers. For their part, the neighborhoods surrounding the capital, although affected and excluded from hygienist policies, chose to move away from them and solve the deficiencies with their own resources (they resorted to the waste that was left from the dried lake of Mexico to continue their lake practices). All of this points to a paradox that shapes our contemporary concerns: on the one hand, the benefits derived from medical knowledge and its technological applications (in this work referring particularly to the urban health system) and, on the other, the alteration it caused in environmental settings. Places like Cuernavaca (classified by the nineteenth-century and hygienists of the first decades of the twentieth century as backward), as well as landscapes such as neighborhoods, affected by advances in sanitary engineering, keep in their memory buried practices that we observe today as possible ways to reestablish environmental balances: alternative uses of water; recycling of organic materials; local uses of fauna; various systems for breaking down excreta, and so on. In sum, what the nineteenth and first half of the twentieth centuries graduated as levels of backwardness or progress, turn out to be key information to rethink the routes of environmental conservation. When we return to the observations of the scientists, politicians and lawyers of that period, we find historically rejected cultural alterity. Populations such as Cuernavaca that, due to their history, orography and/or insufficiency of federal policies, kept different relationships with the environment, today give us clues to reorient basic elements of cities: alternative uses of water, waste of raw materials, organic or consumption of local products, among others. It is, therefore, a matter of unearthing the rejected that cries out to emerge to the surface.Keywords: sanitary hygiene, Mexico city, cultural alterity, environmental conservation, environmental history
Procedia PDF Downloads 1642106 The Grand Unified Theory of Everything as a Generalization to the Standard Model Called as the General Standard Model
Authors: Amir Deljoo
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The endeavor to comprehend the existence have been the center of thought for human in form of different disciplines and now basically in physics as the theory of everything. Here, after a brief review of the basic frameworks of thought, and a history of thought since ancient up to present, a logical methodology is presented based on a core axiom after which a function, a proto-field and then a coordinates are explained. Afterwards a generalization to Standard Model is proposed as General Standard Model which is believed to be the base of the Unified Theory of Everything.Keywords: general relativity, grand unified theory, quantum mechanics, standard model, theory of everything
Procedia PDF Downloads 1002105 The Impact of the Plagal Cadence on Nineteenth-Century Music
Authors: Jason Terry
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Beginning in the mid-nineteenth century, hymns in the Anglo-American tradition often ended with the congregation singing ‘amen,’ most commonly set to a plagal cadence. While the popularity of this tradition is well-known still today, this research presents the origins of this custom. In 1861, Hymns Ancient & Modern deepened this convention by concluding each of its hymns with a published plagal-amen cadence. Subsequently, hymnals from a variety of denominations throughout Europe and the United States heavily adopted this practice. By the middle of the twentieth century the number of participants singing this cadence had suspiciously declined; however, it was not until the 1990s that the plagal-amen cadence all but disappeared from hymnals. Today, it is rare for songs to conclude with the plagal-amen cadence, although instrumentalists have continued to regularly play a plagal cadence underneath the singers’ sustained finalis. After examining a variety of music theory treatises, eighteenth-century newspaper articles, manuscripts & hymnals from the last five centuries, and conducting interviews with a number of scholars around the world, this study presents the context of the plagal-amen cadence through its history. The association of ‘amen’ and the plagal cadence was already being discussed during the late eighteenth century, and the plagal-amen cadence only grew in attractiveness from that time forward, most notably in the nineteenth and twentieth centuries. Throughout this research, the music of Thomas Tallis, primarily through his Preces and Responses, is reasonably shown to be the basis for the high status of the plagal-amen cadence in nineteenth- and twentieth-century society. Tallis’s immediate influence was felt among his contemporary English composers as well as posterity, all of whom were well-aware of his compositional styles and techniques. More importantly, however, was the revival of his music in nineteenth-century England, which had a greater impact on the plagal-amen tradition. With his historical title as the father of English cathedral music, Tallis was favored by the supporters of the Oxford Movement. Thus, with society’s view of Tallis, the simple IV–I cadence he chose to pair with ‘amen’ attained a much greater worth in the history of Western music. A musical device such as the once-revered plagal-amen cadence deserves to be studied and understood in a more factual light than has thus far been available to contemporary scholars.Keywords: amen cadence, Plagal-amen cadence, singing hymns with amen, Thomas Tallis
Procedia PDF Downloads 2332104 Placenta A Classical Caesarean Section with Peripartum Hysterectomy at 27+3 Weeks Gestation For Placnta Accreta
Authors: Huda Abdelrhman Osman Ahmed, Paul Feyi Waboso
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Introduction: Placenta accreta spectrum (PAS) disorders present a significant challenge in obstetric management due to the high risk of hemorrhage and potential complications at delivery. This case describes a 27+3 weeks gestation in a patient with placenta accreta managed with classical cesarean section and peripartum hysterectomy. Case Description: AGravida 4P3 patient presented at 27+3 weeks gestation with painless, unprovoked vaginal bleeding and an estimated blood loss (EBL) of 300 mL. At the 20+5 week anomaly scan, a placenta previa was identified anterior, covering the os anterior uterus and containing lacunae with signs of myometrial thinning. At a 24+1 week scan conducted at a tertiary center, further imaging indicated placenta increta with invasion into the myometrium and potential areas of placenta percreta. The patient’s past obstetric history included three previous cesarean sections, with no significant medical or surgical history. Social history revealed heavy smoking but no alcohol use. No drug allergies were reported. Given the risks associated with PAS, a management plan was formulated, including an MRI at a later stage and cesarean delivery with a possible hysterectomy between 34-36 weeks. However, at 27+3 weeks, the patient experienced another episode of vaginal bleeding EBL 500 ml, necessitating immediate intervention. Management: As the patient was unstable, she was not transferred to the tertiary center. Completed and informed consent was obtained. MDT planning-group and cross-matching 4 units, uterotonics. Tranexamic acid blood products, cryo, cell salvage, 2 obstetric consultants and an anesthetic consultant, blood bank aware and hematologist. HDU bed and ITU availability. This study assisted in performing a classical Caesarean section, Where the urologist inserted JJ ureteric stents. Following this, we also assisted in a total abdominal hysterectomy with the conservation of ovaries. 4 units RBC and 1 unit FFP were transfused. The total blood loss was 2.3 L. Outcome: The procedure successfully achieved hemostasis, and the neonate was delivered with subsequent transfer to a neonatal intensive care unit for management. The patient’s postoperative course was monitored closely with no immediate complications. Discussion: This case highlights the complexity and urgency in managing placenta accreta spectrum disorders, particularly with the added challenges posed by remote location and limited tertiary support. The need for rapid decision-making and interdisciplinary coordination is emphasized in such high-risk obstetric cases. The case also underscores the potential for surgical intervention and the importance of family involvement in emergent care decisions. Conclusion: Placenta accreta spectrum disorders demand meticulous planning and timely intervention. This case contributes to understanding PAS management at earlier gestational ages and provides insights into the challenges posed by access to tertiary care, especially in urgent situations.Keywords: Accreta, Hysterectomy, 3MDT, prematurity
Procedia PDF Downloads 102103 Prevalence and Correlates of Complementary and Alternative Medicine Use among Diabetic Patients in Lebanon: A Cross-Sectional Study
Authors: Farah Naja, Mohamad Alameddine
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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy
Procedia PDF Downloads 3492102 Sociology of Vis and Ramin
Authors: Farzane Yusef Ghanbari
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A sociological analysis on the ancient poetry of Vis and Ramin reveals important points about the political, cultural, and social conditions of the Iranian ancient history. The reciprocal relationship between the effect and structure of society helps the understanding and interpretation of the work. Therefore, informed by the Goldman genetic structuralism and through a glance at social epistemology, this study attempts to explain the role of spell in shaping the social knowledge of ancient people. The results suggest that due to the lack of a central government, and secularism in politics and freedom of speech and opinion, such romantic stories as Vis and Ramin, with a focal female character, has emerged.Keywords: persian literature, Vis and Ramin, sociology, developmental structuralism
Procedia PDF Downloads 4302101 The Embodied World — A Redefinition of "Emptiness" in Heart Sutra from the Perspective of Cognitive Science
Authors: Ke Ma
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Through the long course of history, Buddhism has captivated generations of brilliant minds with its enlightening but elusive discernment. Far from religious dogmas, Buddhism not only represents spiritual revelation, but also logical reasoning.Among all of Buddhism’s concepts, emptiness is the most famous, and abstruse one. This word resulted from an inaccurate translation confuses both Buddhists and religious scholars who understand Heart Sutra based on its English version. In this essay, the idea of “emptiness” will be reinterpreted as “information,” leading not only to a clarification of the ideology of Buddhism, but also to greater correspondence between Buddhism concepts and cognitive science.Keywords: religion, cognitive science, psychology, Buddhism
Procedia PDF Downloads 2722100 Constitutive Role of Light in Christian Sacred Architecture
Authors: Sokol Gojnik, Zorana; Gojnik, Igor
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Light is the central theme of sacred architecture of all religions and so of Christianity. The aim of this paper is to emphasize the inner sense of light and its constitutive role in Christian sacred architecture. The theme of light in Christian sacred architecture is fundamentally connected to its meaning and symbolism of light in Christian theology and liturgy. This fundamental connection is opening the space to the symbolic and theological comprehending of light which was present throughout the history of Christianity and which is lacking in contemporary sacred architecture.Keywords: light, sacred architecture, religious architecture, phenomenology of architecture
Procedia PDF Downloads 2352099 An Analytical Formulation of Pure Shear Boundary Condition for Assessing the Response of Some Typical Sites in Mumbai
Authors: Raj Banerjee, Aniruddha Sengupta
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An earthquake event, associated with a typical fault rupture, initiates at the source, propagates through a rock or soil medium and finally daylights at a surface which might be a populous city. The detrimental effects of an earthquake are often quantified in terms of the responses of superstructures resting on the soil. Hence, there is a need for the estimation of amplification of the bedrock motions due to the influence of local site conditions. In the present study, field borehole log data of Mangalwadi and Walkeswar sites in Mumbai city are considered. The data consists of variation of SPT N-value with the depth of soil. A correlation between shear wave velocity (Vₛ) and SPT N value for various soil profiles of Mumbai city has been developed using various existing correlations which is used further for site response analysis. MATLAB program is developed for studying the ground response analysis by performing two dimensional linear and equivalent linear analysis for some of the typical Mumbai soil sites using pure shear (Multi Point Constraint) boundary condition. The model is validated in linear elastic and equivalent linear domain using the popular commercial program, DEEPSOIL. Three actual earthquake motions are selected based on their frequency contents and durations and scaled to a PGA of 0.16g for the present ground response analyses. The results are presented in terms of peak acceleration time history with depth, peak shear strain time history with depth, Fourier amplitude versus frequency, response spectrum at the surface etc. The peak ground acceleration amplification factors are found to be about 2.374, 3.239 and 2.4245 for Mangalwadi site and 3.42, 3.39, 3.83 for Walkeswar site using 1979 Imperial Valley Earthquake, 1989 Loma Gilroy Earthquake and 1987 Whitter Narrows Earthquake, respectively. In the absence of any site-specific response spectrum for the chosen sites in Mumbai, the generated spectrum at the surface may be utilized for the design of any superstructure at these locations.Keywords: deepsoil, ground response analysis, multi point constraint, response spectrum
Procedia PDF Downloads 1802098 The Role of Flexible Cystoscopy in Managing Recurrent Urinary Tract Infections in Patients with Mesh Implants
Authors: George Shaker, Maike Eylert
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Recurrent urinary tract infections (UTIs) in patients with mesh implants, particularly following pelvic or abdominal surgeries, pose significant clinical challenges. This paper investigates whether flexible cystoscopy is an essential diagnostic and therapeutic tool in managing such patients. With the increasing prevalence of mesh-related complications, it is crucial to explore how diagnostic procedures like cystoscopy can aid in identifying mesh-associated issues that contribute to recurrent UTIs. While flexible cystoscopy is commonly used to evaluate lower urinary tract conditions, its necessity in cases involving patients with mesh implants remains under debate. This study aims to determine the value of flexible cystoscopy in identifying complications such as mesh erosion, fistula formation, and chronic inflammation, which may contribute to recurrent infections. The research compares patients who underwent flexible cystoscopy to those managed without this procedure, examining the diagnostic yield of cystoscopy in detecting mesh-related complications. Furthermore, the study investigates the relationship between recurrent UTIs and the mechanical effects of mesh on the urinary tract, as well as the potential for cystoscopy to guide treatment decisions, such as mesh removal or revision. The results indicate that while flexible cystoscopy can identify mesh-related complications in some cases, its routine use may not be necessary for all patients with recurrent UTIs and mesh. The study emphasizes the importance of patient selection, clinical history, and symptom severity in deciding whether to employ cystoscopy. In cases where there are clear signs of mesh erosion or unexplained recurrent infections despite standard treatments, cystoscopy proves valuable. However, the study also highlights potential risks and discomfort associated with the procedure, suggesting that cystoscopy should be reserved for select cases where non-invasive methods fail to provide clarity. The research concludes that while flexible cystoscopy remains a valuable tool in certain cases, its routine use for all patients with recurrent UTIs and mesh is not justified. The paper provides recommendations for clinical guidelines, emphasizing a more personalized approach to diagnostics that considers the patient’s overall condition, infection history, and mesh type.Keywords: flexible cystoscopy, recurrent urinary tract infections, mesh implants, mesh erosion, diagnostic procedures, urology
Procedia PDF Downloads 182097 Cairo’s Inferno of Pollution: Ecocritical Reading of “The Breeze Hunter” by Egyptian Writer Mohammed Makhzangi
Authors: Mila Fantinelli
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Cairo is the perfect modern representation of a living hell between rising temperatures and failing architecture. The works of Egyptian writer Mohamed Makhzangi may prove to add more depth to the debate that surrounds the topic of pollution in Arab literature. This Egyptian writer, who studied medicine and psychiatry before dedicating his life to writing, sheds indeed further light on the ecological condition of Cairo. In relation to this, the short story “The breeze hunter” (2018) tackles the topic of “environmental architecture”, citing the research of Hassan Fathy in “Architecture for the Poor: An Experiment in Rural Egypt” which provides examples from history of inventions to counter the effects of the hot weather. Specifically, the main character of the story is a man living in Cairo in a small apartment, which turns into a living hell in the summer season because of the high temperatures. Catastrophic urban planning, therefore, prevents the mitigation of the torrid climate but rather worsens it. Makhzangi indeed refers to the environmental issue of pollution caused by the excessive number of air conditioners, which transform Cairo into an infernal island of heat while our country becomes warmer with the passing of time. His description of the city already intersects ecocriticism and environmental issues, tackling the topic of pollution inside of cities and the impact of climate change, of which Cairo is a perfect example. History has indeed provided ways in order to reduce the heat inside houses. Yet, these have all been ignored. As a result, through the teachings of Hassan Fathy, the narrator of the story builds an opening in the house to catch the natural breeze coming from the north. He, therefore, becomes the breeze hunter of Mansoura. However, polluted waves interrupt this brief rest, thus leading to a worsening of his conditions, leading to him suffering from the effects of crowding and the consequences of climate change and pollution. Makhzangi, therefore, reflects on how architecture and urbanism affect the psychological sanity of people and how the situation is worsened by the catastrophic consequences of climate change and pollution.Keywords: ecocriticism, Arabic literature, pollution, environmental architecture, crowding
Procedia PDF Downloads 232096 The Importance of Oral Mucosal Biopsy Selection Site in Areas of Field Change: A Case Report
Authors: Timmis W., Simms M., Thomas C.
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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco
Procedia PDF Downloads 1122095 Vertical and Horizantal Distribution Patterns of Major and Trace Elements: Surface and Subsurface Sediments of Endhorheic Lake Acigol Basin, Denizli Turkey
Authors: M. Budakoglu, M. Karaman
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Lake Acıgöl is located in area with limited influences from urban and industrial pollution sources, there is nevertheless a need to understand all potential lithological and anthropogenic sources of priority contaminants in this closed basin. This study discusses vertical and horizontal distribution pattern of major, trace elements of recent lake sediments to better understand their current geochemical analog with lithological units in the Lake Acıgöl basin. This study also provides reliable background levels for the region by the detailed surfaced lithological units data. The detail results of surface, subsurface and shallow core sediments from these relatively unperturbed ecosystems, highlight its importance as conservation area, despite the high-scale industrial salt production activity. While P2O5/TiO2 versus MgO/CaO classification diagram indicate magmatic and sedimentary origin of lake sediment, Log(SiO2/Al2O3) versus Log(Na2O/K2O) classification diagrams express lithological assemblages of shale, iron-shale, vacke and arkose. The plot between TiO2 vs. SiO2 and P2O5/TiO2 vs. MgO/CaO also supports the origin of the primary magma source. The average compositions of the 20 different lithological units used as a proxy for geochemical background in the study area. As expected from weathered rock materials, there is a large variation in the major element content for all analyzed lake samples. The A-CN-K and A-CNK-FM ternary diagrams were used to deduce weathering trends. Surface and subsurface sediments display an intense weathering history according to these ternary diagrams. The most of the sediments samples plot around UCC and TTG, suggesting a low to moderate weathering history for the provenance. The sediments plot in a region clearly suggesting relative similar contents in Al2O3, CaO, Na2O, and K2O from those of lithological samples.Keywords: Lake Acıgöl, recent lake sediment, geochemical speciation of major and trace elements, heavy metals, Denizli, Turkey
Procedia PDF Downloads 4112094 Malignant Ovarian Cancer Ascites Confers Platinum Chemoresistance to Ovarian Cancer Cells: A Combination Treatment with Crizotinib and 2 Hydroxyestradiol Restore Platinum Sensitivity
Authors: Yifat Koren Carmi, Abed Agbarya, Hazem Khamaisi, Raymond Farah, Yelena Shechtman, Roman Korobochka, Jacob Gopas, Jamal Mahajna
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Ovarian cancer (OC), the second most common form of gynecological malignancy, has a poor prognosis and is frequently identified in its late stages. The recommended treatment for OC typically includes a platinum-based chemotherapy, like carboplatin. Nonetheless, OC treatment has proven challenging due to toxicity and development of acquired resistance to therapy. Chemoresistance is a significant obstacle to a long-lasting response in OC patients, believed to arise from alterations within the cancer cells as well as within the tumor microenvironments (TME). Malignant ascites is a presenting feature in more than one-third of OC patients. It serves as a reservoir for a complex mixture of soluble factors, metabolites, and cellular components, providing a pro-inflammatory and tumor-promoting microenvironment for the OC cells. Malignant ascites is also associated with metastasis and chemoresistance. In an attempt to elucidate the role of TME in chemoresistance of OC, we monitored the ability of soluble factors derived from ascites fluids to affect platinum sensitivity of OC cells. This research, compared ascites fluids from non-malignant cirrhotic patients to those from OC patients in terms of their ability to alter the platinum sensitivity of OC cells. Our findings indicated that exposure to OC ascites induces platinum chemoresistance on OC cells in 11 out of 13 cases (85%). In contrast, 75% of cirrhosis ascites (3 out of 4) failed to confer platinum chemoresistance to OC cells. Cytokine array analysis revealed that IL-6, and to a lesser extent HGF were enriched in OC ascites, whereas IL-22 was enriched in cirrhosis ascites. Pharmaceutical inhibitors that target the IL-6/JAK signaling pathway were mildly effective in overcoming the platinum chemoresistance induced by malignant ascites. In contrast, Crizotinib an HGF/c-MET inhibitor, and 2-hydroxyestradiol (2HE2) were effective in restoring platinum chemoresistance to OC. Our findings demonstrate the importance of OC ascites in supporting platinum chemoresistance as well as the potential of a combination therapy with Crizotinib and the estradiol metabolite 2HE2 to regain OC cells chemosensitivity.Keywords: ovarian cancer, platinum chemoresistance, malignant ascites, tumor microenvironment, IL-6, 2-hydroxyestradiol, HGF, crizotinib
Procedia PDF Downloads 692093 Exploring the History of Chinese Music Acoustic Technology through Data Fluctuations
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The study of extant musical sites can provide a side-by-side picture of historical ethnomusicological information. In their data collection on Chinese opera houses, researchers found that one Ming Dynasty opera house reached a width of nearly 18 meters, while all opera houses of the same period and after it was far from such a width, being significantly smaller than 18 meters. The historical transient fluctuations in the data dimension of width that caused Chinese theatres to fluctuate in the absence of construction scale constraints have piqued the interest of researchers as to why there is data variation in width. What factors have contributed to the lack of further expansion in the width of theatres? To address this question, this study used a comparative approach to conduct a venue experiment between this theater stage and another theater stage for non-heritage opera performances, collecting the subjective perceptions of performers and audiences at different theater stages, as well as combining BK Connect platform software to measure data such as echo and delay. From the subjective and objective results, it is inferred that the Chinese ancients discovered and understood the acoustical phenomenon of the Haas effect by exploring the effect of stage width on musical performance and appreciation of listening states during the Ming Dynasty and utilized this discovery to serve music in subsequent stage construction. This discovery marked a node of evolution in Chinese architectural acoustics technology driven by musical demands. It is also instructive to note that, in contrast to many of the world's "unsuccessful civilizations," China can use a combination of heritage and intangible cultural research to chart a clear, demand-driven course for the evolution of human music technology, and that the findings of such research will complete the course of human exploration of music acoustics. The findings of such research will complete the journey of human exploration of music acoustics, and this practical experience can be applied to the exploration and understanding of other musical heritage base data.Keywords: Haas effect, musical acoustics, history of acoustical technology, Chinese opera stage, structure
Procedia PDF Downloads 1842092 The Modern Era in the Cricket World: How Far Have We Really Come?
Authors: Habib Noorbhai
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History of Cricket: Cricket has a known history spanning from the 16th century till present, with international matches having been played since 1844. The game of cricket arrived in Australia as soon as colonization began in 1788. Cricketers started playing on turf wickets in the late 1800’s and dimensions for both the boundary and pitch later became assimilated. As the years evolved, cricket bats and balls, protective equipment, playing surfaces and the three formats of the game adapted to the playing conditions and laws of cricket. Business of Cricket: During the late 1900's, the shorter version of the game (T20) was introduced in order to attract the crowds to stadiums and television viewers for broadcasting rights. One could argue if this was merely a business venture or a platform for enhancing the performance of cricketers. Between the 16th and 20th century, cricket was a common sport played for passion and pure enjoyment. Industries saw a potential in diversified business ventures in the game (as well as other sports played globally) and cricket subsequently became a career for players, administrators and coaches, the media, health professionals, managers and the corporate world. Pros and Cons of Cricket Developments: At present, the game has significantly gained from the use of technology, sports sciences and varied mechanisms to optimize the performances and forecast frameworks for injury prevention in cricket players. Unfortunately, these had not been utilized in the earlier times of cricket and it would prove interesting to observe how the greats of the game would have benefited with such developments. Cricketers in the 21st century are faced with many overwhelming commitments. One of these is playing cricket for 11 months in a year, making it more than 250 days away from home and their families. As the demand of player contracts increase, the supply of commitment and performances from players increase. Way Forward and Future Implications: The questions are: Are such disadvantages contributing to the overload and injury risks of players? How far have we really come in the cricketing world or has everything since the game’s inception become institutionalized with a business model? These are the fundamental questions which need to be addressed and legislation, policies and ethical considerations need to be drafted and implemented. These will ensure that there is equilibrium of effective transitions and management of not only the players, but also the credibility of the wonderful game.Keywords: enterprising business of cricket, technology, legislation, credibility
Procedia PDF Downloads 4482091 The Medieval Byzantine Churches at Trebizond (Trabzon): Promotion of Local Awareness and Conservation through Interpretation and Presentation
Authors: Esra Ceren Kara, Ufuk Seri̇n
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The Byzantine Empire, which persisted from the 4th to 15th centuries, covered a significant period in history and bequeathed a significant cultural heritage throughout its territories, including Turkey. However, despite its historical and cultural importance, the approach of the political authorities, which emphasizes the Seljuk and Ottoman heritage, to Byzantium in Turkey is reluctant and problematic. Byzantine history and culture have long been neglected and attained negative connotations. This has led to a lack of awareness and understanding of Byzantine heritage among the public and inadequate conservation efforts. This research aims to address this problem by proposing a reinterpretation and presentation of Byzantine heritage in Turkey that emphasizes its cultural value and presents it to the public as a part of a common cultural heritage in order to accomplish effective conservation, raise awareness and provide a better understanding of the Byzantium. In this article, the ways to interpret, present and integrate the Medieval Byzantine heritage into today’s world are analyzed through the selected case study of Trebizond (Trabzon) with a holistic approach by putting emphasis on the Byzantine religious edifices, churches, chapels and monasteries. Although the vestiges of this period are still intact and in use today, their past is unknown to many of their users. This situation is even more evident in the case of the converted churches, which are now used as mosques or mosque-museums. In the city center of Trebizond, 9 out of 12 religious edifices that are still in use were built during the Medieval Byzantine period and converted into mosques under Ottoman and Turkish rule. Currently, these monuments serve as mosques and mosque-museums. However, with the exception of Hagia Sophia and Girls Monastery, their Byzantine past is obscure to many locals. Thus, the promotion of local awareness and conservation of the Medieval Byzantine heritage in the city is required. With this premise, this research will investigate the values and opportunities offered by the Byzantine cultural heritage in Trebizond and the threats to its conservation, and it will offer proposals for a more effective interpretation and presentation so as to foster local awareness and integration of the Medieval Byzantine heritage.Keywords: Byzantium/Byzantine, Trebizond, cultural heritage, interpretation and presentation, conservation, religious architecture, converted churches interpretation and presentation
Procedia PDF Downloads 782090 A Financial Analysis of the Current State of IKEA: A Case Study
Authors: Isabela Vieira, Leonor Carvalho Garcez, Adalmiro Pereira, Tânia Teixeira
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In the present work, we aim to analyse IKEA as a company, by focusing on its development, financial analysis and future benchmarks, as well as applying some of the knowledge learned in class, namely hedging and other financial risk mitigation solutions, to understand how IKEA navigates and protects itself from risk. The decision that led us to choose IKEA for our casework has to do with the long history of the company since the 1940s and its high internationalization in 63 different markets. The company also has clear financial reports which aided us in the making of the present essay and naturally, was a factor that contributed to our decision.Keywords: Ikea, financial risk, risk management, hedge
Procedia PDF Downloads 532089 Ectopic Mediastinal Parathyroid Adenoma: A Case Report with Diagnostic and Management Challenges
Authors: Augustina Konadu Larbi-Ampofo, Ekemini Umoinwek
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Background: Hypercalcaemia is a common electrolyte imbalance that increases mortality if poorly controlled. Primary hyperparathyroidism often presents like this with a prevalence of 0.1-0.3%. Management due to an ectopic parathyroid adenoma in the mediastinum is challenging, especially in a patient with a pacemaker. Case Presentation: A 79-year-old woman with a history of a previous cardiac arrest, permanent pacemaker, ischaemic heart disease, bilateral renal calculi, rectal polyps, liver cirrhosis, and a family history of hyperthyroidism presented to the emergency department with acute back pain. Management and Outcome: The patient was diagnosed with primary hyperparathyroidism due to her elevated corrected calcium and parathyroid hormone levels. Parathyroid investigations consisting of an NM MIBI scan, SPECT-CT, 4D parathyroid scan, and an ultrasound scan of the neck and thorax confirmed an ectopic parathyroid adenoma in the mediastinum at the level of the aortic arch, along with benign thyroid nodules. The location of the adenoma warranted a thoracoscopic surgical approach; however, the presence of her pacemaker and other cardiovascular conditions predisposed her to a potentially poorer post-operative outcome. Discussion: Mediastinal ectopic parathyroid adenomas are rare and difficult to diagnose and treat, often needing a multimodal imaging approach for accurate localisation. Surgery is a definitive treatment; however, in this patient, long-term medical treatment with cinacalcet was the only next suitable treatment option. The difficulty with this is that cinacalcet tackles the biochemical markers of the disease entity and not the disease itself, leaving room for what happens next if there is refractory/uncontrolled hypercalcaemia in this patient with a pacemaker. Moreover, the coexistence of her multiple conditions raises the suspicion of an underlying multisystemic or multiple endocrine disorder, with multiple endocrine neoplasia coming to mind, necessitating further genetic or autoimmune investigations. Conclusion: Mediastinal ectopic parathyroid adenomas are rare, with diagnostic and management challenges.Keywords: mediastinal ectopic parathyroid adenoma, hyperparathyroidism, SPECT/CT, nuclear medicine, multimodal imaging
Procedia PDF Downloads 162088 Phantom Phenomena in Subjects after Limb Amutation Who Regularly Practice High Intensity Sports
Authors: Jolanta Uszko, Tomasz Wloch, Aneta Pirowska, Roman Nowobilski
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Introduction: Phantom phenomena are often reported by subjects who have undergone limb amputation. Mostly, patients feel the amputated part of the limb as if it was still attached to the body. Two types of phantom phenomena: painless (phantom sensation) and painful (phantom pain) were described. Triggers of phantom sensations and phantom pain, as well as fully effective treatment, have not been clearly described yet. Purpose: To assess the influence of psychosocial factors and some clinical conditions on the occurrence of phantom phenomena in amputee athletes. Subjects: 21 men (age: 31 years, SD = 7.5 years) after lower or upper extremity amputation, who regularly performed high-intensity sports (Amp Football Team Players) were included to the study. Method and equipment: In the research, the following method and tools were used: Questionnaire [Pirowska] adapted for athletes with disabilities, Numerical Rating Scale (NRS) - for phantom pain assessment, McGill Pain Assessment Questionnaire (short version), Beck's Depression Inventory (BDI), State Trait Anxiety Inventory (STAI): X-1 and X-2, shortened version of The World Health Organization Quality of Life (WHOQOLBREFF). Results: In the study group, the lower leg amputations with traumatic etiology were predominant. Phantom sensations were present in all subjects. Half of the respondents claimed to experience phantom sensations at least once a day, paroxysmally. There was a prevalence of phantom sensations characterized as incomplete, immobile limb. Phantom pain was reported by over 85% of respondents. The nature of phantom pain was frequently described as stabbing, squeezing, shooting, pulsing, tiring. There was a significant correlation between phantom pain intensity and anxiety, quality of life, depressive tendencies, perception of phantom pain as the obstacle in daily functioning and intensity of the limb pain before amputation. Conclusions: The etiology of phantom phenomena is complex. Psychological factors seem to have a significant influence on the intensity of the phantom pain. Particular attention should be paid to patients who complain about persistent limb pain before the amputation. These are patients with an increased risk of the phantom pain of relatively high intensity.Keywords: amputation, phantom pain, phantom sensations, adaptive sports
Procedia PDF Downloads 1562087 Plethora of Drivers Transforming Colonial Cities: The Case of Allahabad
Authors: Akanksha Gupta, Vishal Dubey
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In the Neoliberal era, there has been a much-talked discourse about urban issues that arise from a narrow approach of the single rationality of market-driven planning in Indian cities. More to this, India's urban planning is already jeopardized by the captious shortage of infrastructure, a cluster of incoherent governing bodies and implementation mechanism, leading cities to lie in the plethora of urban challenges. In this context, Allahabad (now known as Prayagraj) a city in North India is not an exception. Once known as the most planned splendid Colonial city of the British regime in India collapsed phenomenally because of the incompetent approach of planning machinery, straightforward market-driven accession and lack of attention on urban equity and sustainability. Particularly Civil Lines a Colonial neighbourhood, reached to the zenith of the glorified legacy of the Colonial era, transformed into filthy and congested urban form. Contextually this study contemplates and assesses the chronological episodes of major changes in land management reforms and policies under the ad hoc approach of political economy and land use planning which radically degraded the living environment in the present context. This study would empirically showcase the selected sample area detailing some of the major consequences in terms of gradual change in urban morphology, land use, and function. Here the method of study is primarily a qualitative study implying oral history and other historical methods to exhibit the idiom of planning conundrum. This subsequently reflects the repercussions translated into major issues like unclear land titles, encroachment, and unauthorized development and mushrooming of informal and squatter settlements. In nutshell, the study seeks to distinct out the limitations of the land reform and land management policies, which impacted the general degradation to the beautiful setting of Colonial neighbourhood. The Colonial legacy of Civil Lines now exists in the traces of history- memories of people, who once took pride in its serenity have now witnessed the transformation bit by bit till neo-liberal market forces completely swallow it.Keywords: civil lines, land reforms, policies, urban challenges
Procedia PDF Downloads 1172086 Teachers' Views on Mother Tongue Language Curriculum Development
Authors: Wai Ha Leung
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Mother tongue language (MTL) curriculum is core to school education in most countries/regions' school curriculum. Through mother tongue language learning, students are expected to enhance their understanding of the nation's culture and foster the sense of cultural and ethnic identity. However, MTL education in Hong Kong is complicated by the colonial history. This study examines Hong Kong Chinese language teachers' perceptions of MTL education, and the implication on MTL curriculum development. The questionnaire was administrated to 97 teachers, and interviews were carried out on 17 teachers. Usually, MTL is both the tool with which knowledge and skills are taught and learned and the vehicle for students to learn about the traditions of the countries' literature and culture. In Hong Kong, 95% of the population is of Chinese descent. Traditionally, education in China was a mixture of philosophy, history, politics and literacy. Chinese as an MTL subject in pre-colonial Hong Kong has always been assigned the mission of developing students' cultural identity in addition to the development of linguistic proficiency. During the colonial period, the Chinese Language curriculum shifted to be more language skills based with less emphasis on Chinese culture and moral education. After the sovereignty of Hong Kong was returned to China in 1997, although a new curriculum was implemented in 2002, teaching and learning in school as well as public examinations seem to be remaining language skills oriented instead of culturally based. This deviation from the trend of both Chinese traditional education and global mother tongue language education makes some Chinese language teachers feel confused. In addition, there is comment that in general Hong Kong students' Chinese language proficiency is becoming weaker and weaker in recent years. Thus, effectiveness of the skills oriented language curriculum has come under question. How a language teacher views the aims and objectives of the language subject he or she is teaching has a direct effect on the curriculum delivery and pedagogies used. It is, therefore, important to investigate what is the language teachers' perception of MTL education, and whether the current school curriculum can meet the teachers' expectation as well as achieve the aims of MTL education. Given this context, this study explored the views of Hong Kong Chinese language teachers on MTL education. The data indicate that teachers showed a strong resentment towards the current curriculum. Results may have implications on mother tongue language curriculum development.Keywords: Chinese language education, curriculum development, mother tongue language education, teachers' perception
Procedia PDF Downloads 4892085 Factors Associated with Seroconversion of Oral Polio Vaccine among the Children under 5 Year in District Mirpurkhas, Pakistan 2015
Authors: Muhammad Asif Syed, Mirza Amir Baig
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Background: Pakistan is one of the two remaining polio-endemic countries, posing a significant public health challenge for global polio eradication due to failure to interrupt polio transmission. Country specific seroprevalence studies help in the evaluation of immunization program performance, the susceptibility of population against polio virus and identification of existing level of immunity with factors that affect seroconversion of the oral polio vaccine (OPV). The objective of the study was to find out factors associated with seroconversion of the OPV among children 6-59 months in Pakistan. Methods: A Hospital based cross-sectional serosurvey was undertaken in May-June 2015 at District Mirpurkhas, Sindh-Pakistan. Total 180 children aged 6–59 months were selected by using systematic random sampling from Muhammad Medical College Hospital, Mirpurkhas. Demographic, vaccination history and risk factors information were collected from the parents/guardian. Blood sample was collected and tested for the detection of poliovirus IgG antibodies by using ELISA Kit. The IgG titer <10 IU/ml, 50 to <150 IU/ml and >150 IU/ml was defined as negative, weak positive and positive immunity respectively. Pearson Chi-square test was used to determine the difference in seroprevalence in univariate analysis. Results: A total of 180 subjects were enrolled mean age was 23 months (7 -59 months). Off these 160 (89%) children were well and 18 (10%) partially protected against polio virus. Two (1.1%) children had no protection against polio virus as they had <10 IU/ml poliovirus IgG antibodies titer. Both negative cases belong from the female gender, age group 12-23 months, urban area and BMI <50 percentile. There was a difference between normal and the wasting children; it did attain statistical significance (χ2= 35.5, p=0.00). The difference in seroconversion was also observed in relation to the gender (χ2=6.23, p=0.04), duration of breast feeding (χ2=18.6, p=0.04), history of diarrheal disease before polio vaccine administration (χ2=7.7, p=0.02), and stunting (χ2= 114, p=0.00). Conclusion: This study demonstrated that near 90% children achieve seroconversion of OPV and well protected against polio virus. There is an urgent need to focus on factors like duration of breast feeding, diarrheal diseases and malnutrition (acute and chronic) among the children as an immunization strategy.Keywords: seroconversion, oral polio vaccine, Polio, Pakistan
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