Search results for: history of psychiatry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2644

Search results for: history of psychiatry

1954 Seismic Fragility Assessment of Continuous Integral Bridge Frames with Variable Expansion Joint Clearances

Authors: P. Mounnarath, U. Schmitz, Ch. Zhang

Abstract:

Fragility analysis is an effective tool for the seismic vulnerability assessment of civil structures in the last several years. The design of the expansion joints according to various bridge design codes is almost inconsistent, and only a few studies have focused on this problem so far. In this study, the influence of the expansion joint clearances between the girder ends and the abutment backwalls on the seismic fragility assessment of continuous integral bridge frames is investigated. The gaps (ranging from 60 mm, 150 mm, 250 mm and 350 mm) are designed by following two different bridge design code specifications, namely, Caltrans and Eurocode 8-2. Five bridge models are analyzed and compared. The first bridge model serves as a reference. This model uses three-dimensional reinforced concrete fiber beam-column elements with simplified supports at both ends of the girder. The other four models also employ reinforced concrete fiber beam-column elements but include the abutment backfill stiffness and four different gap values. The nonlinear time history analysis is performed. The artificial ground motion sets, which have the peak ground accelerations (PGAs) ranging from 0.1 g to 1.0 g with an increment of 0.05 g, are taken as input. The soil-structure interaction and the P-Δ effects are also included in the analysis. The component fragility curves in terms of the curvature ductility demand to the capacity ratio of the piers and the displacement demand to the capacity ratio of the abutment sliding bearings are established and compared. The system fragility curves are then obtained by combining the component fragility curves. Our results show that in the component fragility analysis, the reference bridge model exhibits a severe vulnerability compared to that of other sophisticated bridge models for all damage states. In the system fragility analysis, the reference curves illustrate a smaller damage probability in the earlier PGA ranges for the first three damage states, they then show a higher fragility compared to other curves in the larger PGA levels. In the fourth damage state, the reference curve has the smallest vulnerability. In both the component and the system fragility analysis, the same trend is found that the bridge models with smaller clearances exhibit a smaller fragility compared to that with larger openings. However, the bridge model with a maximum clearance still induces a minimum pounding force effect.

Keywords: expansion joint clearance, fiber beam-column element, fragility assessment, time history analysis

Procedia PDF Downloads 424
1953 Patient-Reported Adverse Drug Reactions, Medication Adherence and Clinical Outcomes among major depression disorder Patients in Ethiopia: A Prospective Hospital Based Study.

Authors: Tadesse Melaku Abegaz

Abstract:

Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

Procedia PDF Downloads 237
1952 Contribution of PALB2 and BLM Mutations to Familial Breast Cancer Risk in BRCA1/2 Negative South African Breast Cancer Patients Detected Using High-Resolution Melting Analysis

Authors: N. C. van der Merwe, J. Oosthuizen, M. F. Makhetha, J. Adams, B. K. Dajee, S-R. Schneider

Abstract:

Women representing high-risk breast cancer families, who tested negative for pathogenic mutations in BRCA1 and BRCA2, are four times more likely to develop breast cancer compared to women in the general population. Sequencing of genes involved in genomic stability and DNA repair led to the identification of novel contributors to familial breast cancer risk. These include BLM and PALB2. Bloom's syndrome is a rare homozygous autosomal recessive chromosomal instability disorder with a high incidence of various types of neoplasia and is associated with breast cancer when in a heterozygous state. PALB2, on the other hand, binds to BRCA2 and together, they partake actively in DNA damage repair. Archived DNA samples of 66 BRCA1/2 negative high-risk breast cancer patients were retrospectively selected based on the presence of an extensive family history of the disease ( > 3 affecteds per family). All coding regions and splice-site boundaries of both genes were screened using High-Resolution Melting Analysis. Samples exhibiting variation were bi-directionally automated Sanger sequenced. The clinical significance of each variant was assessed using various in silico and splice site prediction algorithms. Comprehensive screening identified a total of 11 BLM and 26 PALB2 variants. The variants detected ranged from global to rare and included three novel mutations. Three BLM and two PALB2 likely pathogenic mutations were identified that could account for the disease in these extensive breast cancer families in the absence of BRCA mutations (BLM c.11T > A, p.V4D; BLM c.2603C > T, p.P868L; BLM c.3961G > A, p.V1321I; PALB2 c.421C > T, p.Gln141Ter; PALB2 c.508A > T, p.Arg170Ter). Conclusion: The study confirmed the contribution of pathogenic mutations in BLM and PALB2 to the familial breast cancer burden in South Africa. It explained the presence of the disease in 7.5% of the BRCA1/2 negative families with an extensive family history of breast cancer. Segregation analysis will be performed to confirm the clinical impact of these mutations for each of these families. These results justify the inclusion of both these genes in a comprehensive breast and ovarian next generation sequencing cancer panel and should be screened simultaneously with BRCA1 and BRCA2 as it might explain a significant percentage of familial breast and ovarian cancer in South Africa.

Keywords: Bloom Syndrome, familial breast cancer, PALB2, South Africa

Procedia PDF Downloads 220
1951 Screening of Commonly Used Reinforcement Materials for Tomb Murals

Authors: Liping Qiu, Xiaofeng Zhang

Abstract:

In its long history, precious tomb murals suffered from various diseases due to natural and man-made destruction. The key to how to protect tomb murals is how to strengthen and protect the tomb murals. In order to maximize the life of the tomb murals, the artistic, historic, and scientific values of the tomb murals can be continued. In this paper, four kinds of traditional reinforcement materials (silicone acrylic lotion, pure acrylic lotion, polyvinyl acetate lotion, and B72) are selected to reinforce the ground support layer of tomb murals, and the reinforcement effect of each reinforcement material on the ground support layer of murals is compared and analyzed, and the best protection material is obtained.

Keywords: mural, destruction cycle, reinforcement material, disease

Procedia PDF Downloads 113
1950 Exploring White-Matter Hyperintensities in Patients with Psychiatric Disorders and Their Clinical Relevance

Authors: Ubaid Ullah Kamgar, Ajaz Ahmed Suhaff, Mohammad Maqbool Dar

Abstract:

Objective: The aim is to study the association of MRI findings of T₂/FLAIR white matter hyperintensities among patients with psychiatric disorders. Background and Rationale: MRI findings in psychiatric disorders can vary widely depending on specific disorders and individual differences. However, some general patterns have been observed, such as, in Depression - reduced volume in areas such as the prefrontal cortex and hippocampus; in Schizophrenia - enlarged ventricles, abnormalities in frontal and temporal lobes, as well as hippocampus and thalamus; in Bipolar Disorder – reduced volume in the prefrontal cortex and hippocampus and abnormalities in the amygdala; in OCD – abnormalities in the orbitofrontal cortex, anterior cingulate cortex and striatum. However, many patients show findings of white-matter hyper-intensities, which are usually considered non-specific in psychiatry. These hyperintensities are low attenuation in the deep and white matter. The pathogenic mechanisms of white matter hyperintensities are not well-understood and have been attributed to cerebral small vessel disease. The aim of the study is to study the association of the above MRI findings in patients with psychiatric disorders after ruling out neurological disorders (if any are found). Methodology: Patients admitted to psychiatric hospitals or presenting to OPDs with underlying psychiatric disorders, having undergone MRI Brain as part of investigations, and having T₂/FLAIR white-matter hyperintensities on MRI were taken to study the association of the above MRI findings with different psychiatric disorders. Results: Out of the 22 patients having MRI findings of T₂/FLAIR white-matter hyper-intensities, the underlying psychiatric comorbidities were: Major Depressive Disorder in 7 pts; Obsessive Compulsive Disorder in 5 pts; Bipolar Disorder in 5 pts; Dementia (vascular type) in 5pts. Discussion and conclusion: In our study, the white matter hyper-intensities were found mostly in MDD (32%), OCD (22.7%), Bipolar Disorder (22.7%) and Dementia in 22.7% of patients. In conclusion, the presence of white-matter hyperintensities in psychiatric disorders underscores the complex interplay between vascular, neurobiological and psychosocial factors. Further research with a large sample size is needed to fully elucidate their clinical significance.

Keywords: white-matter hyperintensities, OCD, MDD, dementia, bipolar disorder.

Procedia PDF Downloads 45
1949 Jarcho-Levin Syndrome: A Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

Procedia PDF Downloads 49
1948 Factor Associated with Uncertainty Undergoing Hematopoietic Stem Cell Transplantation

Authors: Sandra Adarve, Jhon Osorio

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Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

Procedia PDF Downloads 152
1947 The New Face of TV: An Exploratory Study on the Effects of Snapchat on TV Ratings in Kuwait

Authors: Bashaiar Alsanaa

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The advent of new forms of media has always led to a change in the way existing media deliver content. No medium has been replaced by another yet over the course of history. Whether this fact changes with the introduction of new age technology and social media remains to be seen. Snapchat may be the first application, to seriously challenge TV. It is perhaps the new face of television. The individualistic nature of Snapchat, whereby users control who, when, and in what order to watch, assesses user freedom from traditional broadcasters’ control. This study aims to fill the void in research conducted around such topic. The research explores how Snapchat maybe slowly but replacing TV. The study surveys users in Kuwait in order to present an overview of the topic. It also draws a framework through which implications and suggestions for future research may be discussed to better serve the advancement of media research.

Keywords: Kuwait, media, Snapchat, television

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1946 Aporia, Daze and Arcanes during Visit to Scene of Crime: A Case History

Authors: A. S. Grewal, Sh. Dharambir, R. S. Sangwan, Vikas Dhanda

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Every Scene of Crime is of different kind in nature. Sometimes we see such type of circumstances that we become confused to judge whether the case is of homicide or suicide. In such circumstances a doyen is asked for the option. On the basis of his esoteric knowledge he finds such clues which force the sleuth to change the under sections of Indian penal Code. Here we have examined a case by visiting Scene of Crime and found that a person was found lying dead in a room. There was only one passage which was found opened, the pistol along with the fired cartridge case, misfired cartridge were lying on the spot. Observation method, mathematical calculations, chemical examination and other aspects were considered.

Keywords: country-made pistol, misfired cartridge, fired cartridge case, blackening, nitrite

Procedia PDF Downloads 386
1945 Colorful Ethnoreligious Map of Iraq and the Current Situation of Minorities in the Country

Authors: Meszár Tárik

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The aim of the study is to introduce the minority groups living in Iraq and to shed light on their current situation. The Middle East is a rather heterogeneous region in ethnic terms. It includes many ethnic, national, religious, linguistic, or ethnoreligious groups. The relationship between the majority and minority is the main cause of various conflicts in the region. It seems that most of the post-Ottoman states have not yet developed a unified national identity capable of integrating their multi-ethnic societies. The issue of minorities living in the Middle East is highly politicized and controversial, as the various Arab states consider the treatment of minorities as their internal affair, do not recognize discrimination or even deny the existence of any kind of minorities on their territory. This attitude of the Middle Eastern states may also be due to the fact that the minority issue can be abused and can serve as a reference point for the intervention policies of Western countries at any time. Methodologically, the challenges of these groups are perceived through the manifestos of prominent individuals and organizations belonging to minorities. The basic aim is to present the minorities’ own history in dealing with the issue. It also introduces the different ethnic and religious minorities in Iraq and analyzes their situation during the operation of the terrorist organization „Islamic State” and in the aftermath. It is clear that the situation of these communities deteriorated significantly with the advance of ISIS, but it is also clear that even after the expulsion of the militant group, we cannot necessarily report an improvement in this area, especially in terms of the ability of minorities to assert their interests and physical security. The emergence of armed militias involved in the expulsion of ISIS sometimes has extremely negative effects on them. Until the interests of non-Muslims are adequately represented at the local level and in the legislature, most experts and advocates believe that little will change in their situation. When conflicts flare, many Iraqi citizens usually leave Iraq, but because of the poor public security situation (threats from terrorist organizations, interventions by other countries), emigration causes serious problems not only outside the country’s borders but also within the country. Another ominous implication for minorities is that their communities are very slow if ever, to return to their homes after fleeing their own settlements. An important finding of the study is that this phenomenon is changing the face of traditional Iraqi settlements and threatens to plunge groups that have lived there for thousands of years into the abyss of history. Therefore, we not only present the current situation of minorities living in Iraq but also discuss their future possibilities.

Keywords: Middle East, Iraq, Islamic State, minorities

Procedia PDF Downloads 76
1944 The Impact of Financial Reporting on Sustainability

Authors: Lynn Ruggieri

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The worldwide pandemic has only increased sustainability awareness. The public is demanding that businesses be held accountable for their impact on the environment. While financial data enjoys uniformity in reporting requirements, there are no uniform reporting requirements for non-financial data. Europe is leading the way with some standards being implemented for reporting non-financial sustainability data; however, there is no uniformity globally. And without uniformity, there is not a clear understanding of what information to include and how to disclose it. Sustainability reporting will provide important information to stakeholders and will enable businesses to understand their impact on the environment. Therefore, there is a crucial need for this data. This paper looks at the history of sustainability reporting in the countries of the European Union and throughout the world and makes a case for worldwide reporting requirements for sustainability.

Keywords: financial reporting, non-financial data, sustainability, global financial reporting

Procedia PDF Downloads 162
1943 Historic Fire Occurrence in Hemi-Boreal Forests: Exploring Natural and Cultural Scots Pine Multi-Cohort Fire Regimes in Lithuania

Authors: Charles Ruffner, Michael Manton, Gintautas Kibirkstis, Gediminas Brazaitas, Vitas Marozas, Ekaterine Makrickiene, Rutile Pukiene, Per Angelstam

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In dynamic boreal forests, fire is an important natural disturbance, which drives regeneration and mortality of living and dead trees, and thus successional trajectories. However, current forest management practices focusing on wood production only have effectively eliminated fire as a stand-level disturbance. While this is generally well studied across much of Europe, in Lithuania, little is known about the historic fire regime and the role fire plays as a management tool towards the sustainable management of future landscapes. Focusing on Scots pine forests, we explore; i) the relevance of fire disturbance regimes on forestlands of Lithuania; ii) fire occurrence in the Dzukija landscape for dry upland and peatland forest sites, and iii) correlate tree-ring data with climate variables to ascertain climatic influences on growth and fire occurrence. We sampled and cross-dated 132 Scots pine samples with fire scars from 4 dry pine forest stands and 4 peatland forest stands, respectively. The fire history of each sample was analyzed using standard dendrochronological methods and presented in FHAES format. Analyses of soil moisture and nutrient conditions revealed a strong probability of finding forests that have a high fire frequency in Scots pine forests (59%), which cover 34.5% of Lithuania’s current forestland. The fire history analysis revealed 455 fire scars and 213 fire events during the period 1742-2019. Within the Dzukija landscape, the mean fire interval was 4.3 years for the dry Scots pine forest and 8.7 years for the peatland Scots pine forest. However, our comparison of fire frequency before and after 1950 shows a marked decrease in mean fire interval. Our data suggest that hemi-boreal forest landscapes of Lithuania provide strong evidence that fire, both human and lightning-ignited fires, has been and should be a natural phenomenon and that the examination of biological archives can be used to guide sustainable forest management into the future. Currently, fire use is prohibited by law as a tool for forest management in Lithuania. We recommend introducing trials that use low-intensity prescribed burning of Scots pine stands as a regeneration tool towards mimicking natural forest disturbance regimes.

Keywords: biodiversity conservation, cultural burning, dendrochronology, forest dynamics, forest management, succession

Procedia PDF Downloads 191
1942 Gut Mycobiome Dysbiosis and Its Impact on Intestinal Permeability in Attention-Deficit/Hyperactivity Disorder

Authors: Liang-Jen Wang, Sung-Chou Li, Yuan-Ming Yeh, Sheng-Yu Lee, Ho-Chang Kuo, Chia-Yu Yang

Abstract:

Background: Dysbiosis in the gut microbial community might be involved in the pathophysiology of attention deficit/hyperactivity disorder (ADHD). The fungal component of the gut microbiome, namely the mycobiota, is a hyperdiverse group of multicellular eukaryotes that can influence host intestinal permeability. This study therefore aimed to investigate the impact of fungal mycobiome dysbiosis and intestinal permeability on ADHD. Methods: Faecal samples were collected from 35 children with ADHD and from 35 healthy controls. Total DNA was extracted from the faecal samples, and the internal transcribed spacer (ITS) regions were sequenced using high-throughput next-generation sequencing (NGS). The fungal taxonomic classification was analysed using bioinformatics tools, and the differentially expressed fungal species between the ADHD and healthy control groups were identified. An in vitro permeability assay (Caco-2 cell layer) was used to evaluate the biological effects of fungal dysbiosis on intestinal epithelial barrier function. Results: The β-diversity (the species diversity between two communities), but not α-diversity (the species diversity within a community), reflected the differences in fungal community composition between ADHD and control groups. At the phylum level, the ADHD group displayed a significantly higher abundance of Ascomycota and significantly lower abundance of Basidiomycota than the healthy control group. At the genus level, the abundance of Candida (especially Candida albicans) was significantly increased in ADHD patients compared to the healthy controls. In addition, the in vitro cell assay revealed that C. albicans secretions significantly enhanced the permeability of Caco-2 cells. Conclusions: The current study is the first to explore altered gut mycobiome dysbiosis using the NGS platform in ADHD. The findings from this study indicated that dysbiosis of the fungal mycobiome and intestinal permeability might be associated with susceptibility to ADHD.

Keywords: ADHD, fungus, gut–brain axis, biomarker, child psychiatry

Procedia PDF Downloads 100
1941 Neuromyelitis Optica area Postrema Syndrome(NMOSD-APS) in a Fifteen-year-old Girl: A Case Report

Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

Abstract:

Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

Procedia PDF Downloads 32
1940 Terrorism: Definition, History and Different Approaches in the Analysis of Terrorism Phenomenon

Authors: Shabnam Dadparvar, Laijin Shen, Farzad Ravanbod

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Nowadays, the political phenomenon of terrorism is considered as an effective factor on political, social, and economic changes. It has replaced the recognized political phenomena such as revolutions, wars (total war among two or more political units with distinct identities in the form of national states), coups d’état, insurgencies and etc. and has challenged political life in all its levels (sub national, national, and international political groups). In this paper by using descriptive-analytical method, the authors try to explain the spread of this political phenomenon across the world, its definition and types, also analyze different approaches to understand it. The authors believe that the Logical-Rational approach is the best way to explain and understand this phenomenon.

Keywords: logical approach, psychological- social approach, religious approach, terrorism

Procedia PDF Downloads 318
1939 Targeting and Developing the Remaining Pay in an Ageing Field: The Ovhor Field Experience

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

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

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

Procedia PDF Downloads 119
1938 Islam, Gender and Education in Contemporary Georgia: The Example of Kvemo Kartli

Authors: N. Gelovani, D. Ismailov, S. Bochorishvili

Abstract:

Religious minorities of Georgia include Muslims. Their composition is sufficiently miscellaneous, enclosing both ethnical viewpoint and belonging to the inner Islamic denomination. A majority of Muslims represent Azerbaijanis, who chiefly live in Kvemo Kartli (Bolnisi, Gardabani, Dmanisi, Tetri Tskaro, Marneuli and Tsalka). The catalyst for researchers of Islamic History is the geopolitical interests of Georgia, centuries-old contacts with the Islamic world, the not entirely trivial portion of Islam confessor population, the increasing influence of the Islamic factor in current religious-political processes in the world, the elevating procedure of Muslim religious self-consciousness in the Post-Soviet states, significant challenges of international terrorism, and perspectives of rapid globalization. The rise in the level of religious identity of Muslim citizens of Georgia (first of all of those who are not ethnic Georgians) is noticeable. New mosques have been constructed and, sometimes, even young people are being sent to the religious educational institutions of Muslim countries to gain a higher Islamic education. At a time when gender studies are substantive, the goal of which is to eliminate gender-based discrimination and violence in societies, it is essential in Georgia to conduct researches around the concrete problem – Islamic tradition, woman and education in Georgia. A woman’s right to education is an important indicator of women’s general status in a society. The appropriate resources, innovative analysis of Georgian ethnological materials, and surveying of the population (quantitative and qualitative research reports, working papers), condition the success of these researches. In the presented work, interrelation matters of Islam, gender and education in contemporary Georgia by the example of the Azerbaijani population in Kvemo Kartli during period 1992-2016 are studied. We researched the history of Muslim religious education centers in Tbilisi and Kvemo Kartli (Bolnisi, Gardabani, Dmanisi, Tetri Tskaro, Marneuli and Tsalka) in 1992-2016, on the one hand, and the results of sociological interrogation, on the other. As a result of our investigation, we found that Azeri women in the Kvemo Kartli (Georgia) region mostly receive their education in Georgia and Azerbaijan. Educational and Cultural Institutions are inaccessible for most Azeri women. The main reasons are the absence of educational and religious institutions at their places of residence and state policies towards Georgia’s Muslims. 

Keywords: Islam, gender, Georgia, education

Procedia PDF Downloads 218
1937 An Interesting Case of Management of Life Threatening Calcium Disequilibrium in a Patient with Parathyroid Tumor

Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

Abstract:

The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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1936 Code Switching: A Case Study Of Lebanon

Authors: Wassim Bekai

Abstract:

Code switching, as its name states, is altering between two or more languages in one sentence. The speaker tends to use code switching in his/her speech for better clarification of his/her message to the receiver. It is commonly used in sociocultural countries such as Lebanon because of the various cultures that have come across its lands through history, considering Lebanon is geographically located in the heart of the world, and hence between many cultures and languages. In addition, Lebanon was occupied by Turkish authorities for about 400 years, and later on by the French mandate, where both of these countries forced their languages in official papers and in the Lebanese educational system. In this paper, the importance of code switching in the Lebanese workplace will be examined, stressing the efficiency and amount of the production resulting from code switching in the workplace (factories, universities among other places) in addition to exploring the social, education, religious and cultural factors behind this phenomenon in Lebanon.

Keywords: code switching, Lebanon, cultural, factors

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1935 Values Education in Military Schools and Işıklar Air Force High School Sample

Authors: Mehmet Eren Çelik

Abstract:

Values are notions that help people to decide what is good or not and to direct their attitude. Teaching values has always been very important throughout the history. Values should be thought in younger ages to get more efficiency. Therefore military schools are the last stop to learn values effectively. That’s why values education in military schools has vital importance. In this study the military side of values education is examined. The purpose of the study is to show how important values education is and why military students need values education. First of all what value is and what values education means is clearly explained and values education in schools and specifically in military schools is stated. Then values education in Işıklar Air Force High School exemplifies the given information.

Keywords: Işıklar Air Force High School, military school, values, values education

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1934 Study on Adding Story and Seismic Strengthening of Old Masonry Buildings

Authors: Youlu Huang, Huanjun Jiang

Abstract:

A large number of old masonry buildings built in the last century still remain in the city. It generates the problems of unsafety, obsolescence, and non-habitability. In recent years, many old buildings have been reconstructed through renovating façade, strengthening, and adding floors. However, most projects only provide a solution for a single problem. It is difficult to comprehensively solve problems of poor safety and lack of building functions. Therefore, a comprehensive functional renovation program of adding reinforced concrete frame story at the bottom via integrally lifting the building and then strengthening the building was put forward. Based on field measurement and YJK calculation software, the seismic performance of an actual three-story masonry structure in Shanghai was identified. The results show that the material strength of masonry is low, and the bearing capacity of some masonry walls could not meet the code requirements. The elastoplastic time history analysis of the structure was carried out by using SAP2000 software. The results show that under the 7 degrees rare earthquake, the seismic performance of the structure reaches 'serious damage' performance level. Based on the code requirements of the stiffness ration of the bottom frame (lateral stiffness ration of the transition masonry story and frame story), the bottom frame story was designed. The integral lifting process of the masonry building was introduced based on many engineering examples. The reinforced methods for the bottom frame structure strengthened by the steel-reinforced mesh mortar surface layer (SRMM) and base isolators, respectively, were proposed. The time history analysis of the two kinds of structures, under the frequent earthquake, the fortification earthquake, and the rare earthquake, was conducted by SAP2000 software. For the bottom frame structure, the results show that the seismic response of the masonry floor is significantly reduced after reinforced by the two methods compared to the masonry structure. The previous earthquake disaster indicated that the bottom frame is vulnerable to serious damage under a strong earthquake. The analysis results showed that under the rare earthquake, the inter-story displacement angle of the bottom frame floor meets the 1/100 limit value of the seismic code. The inter-story drift of the masonry floor for the base isolated structure under different levels of earthquakes is similar to that of structure with SRMM, while the base-isolated program is better to protect the bottom frame. Both reinforced methods could significantly improve the seismic performance of the bottom frame structure.

Keywords: old buildings, adding story, seismic strengthening, seismic performance

Procedia PDF Downloads 114
1933 Changing Pattern of Drug Abuse: An Outpatient Department Based Study from India

Authors: Anshu Gupta, Charu Gupta

Abstract:

Background: Punjab, a border state in India has achieved notoriety world over for its drug abuse problem. People right from school kids to elderly are hooked to drugs. This pattern of substance abuse is prevalent in both cities and villages alike. Excess of younger population in India has further aggravated the situation. It is feared that the benefits of India’s economic growth may well be negated by the rising substance abuse especially in this part of the country. It is quite evident that the pattern of substance abuse tends to change over time which is an impediment in the formulation of effective strategies to tackle this issue. Aim: Purpose of the study was to ascertain the change in the pattern of drug abuse for two consecutive years in the out patient department (OPD) population. Method: The study population comprised of all the patients reporting for deaddiction to the psychiatry outpatient department over a period of twelve months for two consecutive years. All the patients were evaluated by the International Classification of Diseases; 10 criteria for substance abuse/dependence. Results: A considerably high prevalence of substance abuse was present in the Indian population. In general, there was an increase in prevalence from first to the second year, especially among the female population. Increase in prevalence of substance abuse appeared to be more prominent among the younger age group of both the sexes. A significant increase in intravenous drug abuse was observed. Peer pressure and parental imitation were the major factors fueling substance abuse. Precipitation or fear of withdrawal symptoms was the major factor preventing abstinence. Substance abuse had a significant effect on the health and interpersonal relations of these patients. Summary/Conclusion: Drug abuse and addiction are on the rise throughout India. Changing cultural values, increasing economic stress and dwindling supportive bonds appear to be leading to initiation of substance abuse. Need of the hour is to formulate a comprehensive strategy to bring about an overall reduction in the use of drugs.

Keywords: deaddiction, peer pressure, parental imitation, substance abuse/dependance

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1932 The Libyc Writing

Authors: S. Ait Ali Yahia

Abstract:

One of the main features of the Maghreb is its linguistic richness. The multilingualism is a fact which always marked the Maghreb since the beginning of the history up to know. Since the arrival of the Phoenicians, followed by the Carthaginians, Romans, and Arabs, etc, there was a social group in the Maghreb which controlled two kinds of idioms. The libyc one remained, despite everything, the local language used by the major part of the population. This language had a support of written transmission attested by many inscriptions. Among all the forms of the Maghreb writing, this alphabet, however, continues to cause a certain number of questions about the origin and the date of its appearance. The archaeological, linguistic and historical data remain insufficient to answer these questions. This did not prevent the researchers from giving an opinion. In order to answer these questions we will expose here the various assumptions adopted by various authors who are founded on more or less explicit arguments. We will also speak about the various forms taken by the libyc writing during antiquity.

Keywords: the alphabet libyc, Eastern libyc, Western libyc, multilingualism

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1931 Politico-Religious Connections to the January 6th Insurrection

Authors: Kirk Johnson, Gabriel Rubin

Abstract:

The January 6th Insurrection on the United States Capitol Building has been one of the most disturbing expressions of violence in American history. While there are numerous reasons that led to such aggression, there are destructive politico-religious ideologies and understandings, known as Christian Nationalism, White Christian Nationalism, and Christian Dominionism that influenced the actions of the January 6th insurrectionists. Such ideas are deeply rooted in the unification of church and state, a theocracy, embedded within the understanding that Biblical scripture is the blueprint on which the functioning of the American government should follow. In addition, the concept of racial hierarchy is embedded in politico-religious principles of White Christian Nationalism. This paper will examine how Christian Dominionism is one factor that influenced the January 6th Insurrection.

Keywords: January 6th insurrection, dominionism, Christian nationalism, polygenism

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1930 Bringing German History to Tourists

Authors: Gudrun Görlitz, Christian Schölzel, Alexander Vollmar

Abstract:

Sites of Jewish Life in Berlin 1933-1945. Between Persecution and Self-assertion” was realized in a project funded by the European Regional Development Fund. A smartphone app, and a associated web site enable tourists and other participants of this educational offer to learn in a serious way more about the life of Jews in the German capital during the Nazi era. Texts, photos, video and audio recordings communicate the historical content. Interactive maps (both current and historical) make it possible to use predefined or self combined routes. One of the manifold challenges was to create a broad ranged guide, in which all detailed information are well linked with each other. This enables heterogeneous groups of potential users to find a wide range of specific information, corresponding with their particular wishes and interests. The multitude of potential ways to navigate through the diversified information causes (hopefully) the users to utilize app and web site for a second or third time and with a continued interest. Therefore 90 locations, a lot of them situated in Berlin’s city centre, have been chosen. For all of them text-, picture and/or audio/video material gives extensive information. Suggested combinations of several of these “site stories” are leading to the offer of detailed excursion routes. Events and biographies are also presented. A few of the implemented biographies are especially enriched with source material concerning the aspect of (forced) migration of these persons during the Nazi time. All this was done in a close and fruitful interdisciplinary cooperation of computer scientists and historians. The suggested conference paper aims to show the challenges shaping complex source material for practical use by different user-groups in a proper technical and didactic way. Based on the historical research in archives, museums, libraries and digital resources the quantitative dimension of the project can be sized as follows: The paper focuses on the following historiographical and technical aspects: - Shaping the text material didactically for the use in new media, especially a Smartphone-App running on differing platforms; - Geo-referencing of the sites on historical and current map material; - Overlay of old and new maps to present and find the sites; - Using Augmented Reality technologies to re-visualize destroyed buildings; - Visualization of black-/white-picture-material; - Presentation of historical footage and the resulting problems to need too much storage space; - Financial and juridical aspects in gaining copyrights to present archival material.

Keywords: smartphone app, history, tourists, German

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1929 School Counseling in Sri Lanka: Analysis of the past Recommending a Way Forward

Authors: Buddhiprabha D. D. Pathirana

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Despite a rapid increase in the number of school counselors in the recent past; procuring the service of school counselors is a luxury that many Sri Lankan schools cannot afford. In addition, school counseling in Sri Lanka also faces new challenges in implementation due to the fact that a generally agreed consensus on training, ethical standards, role identity, counseling model, and structures for school counselors has not been reached. Therefore, this paper has several objectives. First, it reviews a brief history of school counseling in Sri Lanka and describes its current status. Second, it describes current trends/ problems specific to Sri Lankan school counseling milieu which have limited the progress of school counseling as a practice. Third, it discusses societal and cultural issues that are important to consider when implementing school counseling as a practices in Sri Lanka and provides recommendations to improve it.

Keywords: school counseling, Sri Lanka, current situation, recommendations

Procedia PDF Downloads 518
1928 The Racism Found in Capitalism’s Poetry

Authors: Rich Murphy

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‘The Racism Found in Capitalism’s Poetry’ claims that since the death of philosophy and the end of art modern poetry has been upstaged by capitalist poetry using similar strategies and techniques; while both sublime moments use spectacle one is more effective. The essay also claims that capitalist poetry is open to racism and analyzes KFC advertising campaign to produce evidence of wide spread acceptance in an era of ‘micro-aggressions’ and confederate flag removals. The essay spends considerable time outlining the history of advertising and the weak literary counters to it that inevitably lent its assistance in education. The essay also suggests that the concept of ‘Enormous Irony’ may be the only way to counter. However, as long as capitalism is the method of the economy and governance, the essay suggests, there was little hope in spite of Obama’s election.

Keywords: modern poetry, advertising, Kentucky fried chicken, capitalism, poetry

Procedia PDF Downloads 240
1927 Systematic Review and Meta-analysis Investigating the Efficacy of Walking-based Aerobic Exercise Interventions to Treat Postpartum Depression

Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

Abstract:

Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

Procedia PDF Downloads 193
1926 Optimization of Structures Subjected to Earthquake

Authors: Alireza Lavaei, Alireza Lohrasbi, Mohammadali M. Shahlaei

Abstract:

To reduce the overall time of structural optimization for earthquake loads two strategies are adopted. In the first strategy, a neural system consisting self-organizing map and radial basis function neural networks, is utilized to predict the time history responses. In this case, the input space is classified by employing a self-organizing map neural network. Then a distinct RBF neural network is trained in each class. In the second strategy, an improved genetic algorithm is employed to find the optimum design. A 72-bar space truss is designed for optimal weight using exact and approximate analysis for the El Centro (S-E 1940) earthquake loading. The numerical results demonstrate the computational advantages and effectiveness of the proposed method.

Keywords: optimization, genetic algorithm, neural networks, self-organizing map

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1925 Serum Sickness-Like Reaction to D-Mannose Supplement

Authors: Emma Plante, Charles Ekwunwa, Diego Illanes

Abstract:

Introduction: Serum Sickness-Like Reaction (SSLR) is an inflammatory immune response characterized by a rash, polyarthralgias, and fever. SSLR usually occurs in response to a new medication (most commonly antibiotics, anticonvulsants, or antiinflammatory agents) and is believed to involve the formation of drug-specific immune complexes. Here we present a case of a 16-year-old female patient who developed an SSLR in response to the D-mannose-containing over-the-counter supplement, Uqora, used to promote bladder health. Methodology: The methodology for this study included a thorough literature search for other cases of SSLR associated with D-Mannose containing products. Data collection was performed through a review of the patient’s medical record, including history, physical examination, relevant laboratory results, and treatment plan. Findings: A 16-year-old female with a history of overactive bladder and anemia presented with a diffuse urticarial rash, headaches, joint pain, and swelling for three days. Her medications included oral contraceptive pills, iron, mirabegron, UQora, and a probiotic. Physical examination revealed a diffuse urticarial rash, and her musculoskeletal exam revealed swelling and tenderness in her wrists. Her CBC, basic metabolic panel, liver function panel, lyme titers, and urinalysis were all within normal limits. The patient was referred to an allergist, who diagnosed her with SSLR. All medications were discontinued, and she was treated with a 7-day course of prednisone and cetirizine. Her symptoms resolved, and her medications were slowly resumed sequentially over several months. However, UQora triggered a recurrence of her symptoms, and it was identified as the culprit medication. Consequently, UQora was permanently discontinued, and the patient has remained symptom-free. Conclusion: This case report describes the first documented case of SSLR caused by UQora (active ingredient D-mannose). D-Mannose is a monosaccharide found in many plants and fruits, and it is commonly used to prevent urinary tract infections. While the clinical features and timeline, in this case, were typical of SSLR, UQora as the trigger was highly unusual. Clinicians should be aware of the diverse triggers of SSLR and the importance of prompt identification and management to enhance patient safety. It is possible D-mannose was not the trigger, and further research is necessary to better understand the potential therapeutic applications of D-mannose, as well as the potential risks and interactions.

Keywords: serum sickness-like reaction, d-mannose, hypersensitivity reaction, urticaria

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