Search results for: mortality map
617 Molecular Epidemiology of Rotavirus in Post-Vaccination Era in Pediatric Patients with Acute Gastroenteritis in Thailand
Authors: Nutthawadee Jampanil, Kattareeya Kumthip, Niwat Maneekarn, Pattara Khamrin
Abstract:
Rotavirus A is one of the leading causes of acute gastroenteritis in children younger than five years of age, especially in low-income countries in Africa and South Asia. Two live-attenuated oral rotavirus vaccines, Rotarix and RotaTeq, have been introduced into routine immunization programs in many countries and have proven highly effective in reducing the burden of rotavirus-associated morbidity and mortality. In Thailand, Rotarix and RotaTeq vaccines have been included in the national childhood immunization program since 2020. The objectives of this research are to conduct a molecular epidemiological study and to characterize rotavirus genotypes circulating in pediatric patients with acute diarrhea in Chiang Mai, Thailand, from 2020-2022 after the implementation of rotavirus vaccines. Out of 858 stool specimens, 26 (3.0%) were positive for rotavirus A. G3P[8] (23.0%) was detected as the most predominant genotype, followed by G1P[8] (19.2%), G8P[8] (19.2%), G9P[8] (15.3%), G2P[4] (7.7%), G1P[6] (3.9%), G9P[4] (3.9%), and G8P[X] (3.9%). In addition, the uncommon rotavirus strain G3P[23] (3.9%) was also detected in this study, and this G3P[23] strain displayed a genetic background similar to the porcine rotavirus. In conclusion, there was a dramatic change in the prevalence of rotavirus A infection and the diversity of rotavirus A genotypes in pediatric patients in Chiang Mai, Northern Thailand, in the rotavirus post-vaccination period. The finding obtained from this research contributes to a better understanding of rotavirus epidemiology after rotavirus vaccine introduction. Furthermore, the identification of unusual G and P genotype combination strains provides significant evidence for the potential interspecies transmission between human and animal rotaviruses.Keywords: rotavirus, infectious disease, gastroenteritis, Thailand
Procedia PDF Downloads 67616 A Study on Compromised Periodontal Health Status among the Pregnant Woman of Jamshedpur, Jharkhand, India
Authors: Rana Praween Kumar
Abstract:
Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery
Procedia PDF Downloads 162615 Assessment of the Role of Plasmid in Multidrug Resistance in Extended Spectrum βEtalactamase Producing Escherichia Coli Stool Isolates from Diarrhoeal Patients in Kano Metropolis Nigeria
Authors: Abdullahi Musa, Yakubu Kukure Enebe Ibrahim, Adeshina Gujumbola
Abstract:
The emergence of multidrug resistance in clinical Escherichia coli has been associated with plasmid-mediated genes. DNA transfer among bacteria is critical to the dissemination of resistance. Plasmids have proved to be the ideal vehicles for dissemination of resistance genes. Plasmids coding for antibiotic resistance were long being recognized by many researchers globally. The study aimed at determining the antibiotic susceptibility pattern of ESBL E. coli isolates claimed to be multidrug resistance using disc diffusion method. Antibacterial activity of the test isolates was carried out using disk diffusion methods. The results showed that, majority of the multidrug resistance among clinical isolates of ESBL E. coli was as a result of acquisition of plasmid carrying antibiotic-resistance genes. Production of these ESBL enzymes by these organisms which are normally carried by plasmid and transfer from one bacterium to another has greatly contributed to the rapid spread of antibiotic resistance amongst E. coli isolates, which lead to high economic burden, increase morbidity and mortality rate, complication in therapy and limit treatment options. To curtail these problems, it is of significance to checkmate the rate at which over the counter drugs are sold and antibiotic misused in animal feeds. This will play a very important role in minimizing the spread of resistance bacterial strains in our environment.Keywords: Escherichia coli, plasmid, multidrug resistance, ESBL, pan drug resistance
Procedia PDF Downloads 68614 Detection of Atrial Fibrillation Using Wearables via Attentional Two-Stream Heterogeneous Networks
Authors: Huawei Bai, Jianguo Yao, Fellow, IEEE
Abstract:
Atrial fibrillation (AF) is the most common form of heart arrhythmia and is closely associated with mortality and morbidity in heart failure, stroke, and coronary artery disease. The development of single spot optical sensors enables widespread photoplethysmography (PPG) screening, especially for AF, since it represents a more convenient and noninvasive approach. To our knowledge, most existing studies based on public and unbalanced datasets can barely handle the multiple noises sources in the real world and, also, lack interpretability. In this paper, we construct a large- scale PPG dataset using measurements collected from PPG wrist- watch devices worn by volunteers and propose an attention-based two-stream heterogeneous neural network (TSHNN). The first stream is a hybrid neural network consisting of a three-layer one-dimensional convolutional neural network (1D-CNN) and two-layer attention- based bidirectional long short-term memory (Bi-LSTM) network to learn representations from temporally sampled signals. The second stream extracts latent representations from the PPG time-frequency spectrogram using a five-layer CNN. The outputs from both streams are fed into a fusion layer for the outcome. Visualization of the attention weights learned demonstrates the effectiveness of the attention mechanism against noise. The experimental results show that the TSHNN outperforms all the competitive baseline approaches and with 98.09% accuracy, achieves state-of-the-art performance.Keywords: PPG wearables, atrial fibrillation, feature fusion, attention mechanism, hyber network
Procedia PDF Downloads 121613 Effect of Haemophilus Influenzae Type B (HIB) Vaccination on Child Anthropometry in India: Evidence from Young Lives Study
Authors: Swati Srivastava, Ashish Kumar Upadhyay
Abstract:
Haemophilus influenzae Type B (Hib) cause infections of pneumonia, meningitis, epiglottises and other invasive disease exclusively among children under age five. Occurrence of these infections may impair child growth by causing micronutrient deficiency. Using longitudinal data from first and second waves of Young Lives Study conducted in India during 2002 and 2006-07 respectively and multivariable logistic regression models (using generalised estimation equation to take into account the cluster nature of sample), this study aims to examine the impact of Hib vaccination on child anthropometric outcomes (stunting, underweight and wasting) in India. Bivariate result shows that, a higher percent of children were stunted and underweight among those who were not vaccinated against Hib (39% & 48% respectively) as compare to those who were vaccinated (31% and 39% respectively).The risk of childhood stunting and underweight was significantly lower among children who were vaccinated against Hib (odds ratio: 0.77, 95% CI: 0.62-0.96 and odds ratio: 0.79, 95% C.I: 0.64-0.98 respectively) as compare to the unvaccinated children. No significant association was found between vaccination status against Hib and childhood wasting. Moreover, in the statistical models, about 13% of stunting and 12% of underweight could be attributable to lack of vaccination against Hib in India. Study concludes that vaccination against Hib- in addition to being a major intervention for reducing childhood infectious disease and mortality- can be consider as a potential tool for reducing the burden of undernutrition in India. Therefore, the Government of India must include the vaccine against Hib into the Universal Immunization Programme in India.Keywords: Haemophilus influenzae Type-B, Stunting, Underweight, Wasting, Young Lives Study (YLS), India
Procedia PDF Downloads 338612 A Case Study of Spontaneous Heterotopic Pregnancy with Subsequent Ruptured Ectopic Pregnancy
Authors: M. Elder, L. Beech, A. Mackie
Abstract:
Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy
Procedia PDF Downloads 139611 Functionalized Carbon-Base Fluorescent Nanoparticles for Emerging Contaminants Targeted Analysis
Authors: Alexander Rodríguez-Hernández, Arnulfo Rojas-Perez, Liz Diaz-Vazquez
Abstract:
The rise in consumerism over the past century has resulted in the creation of higher amounts of plasticizers, personal care products and other chemical substances, which enter and accumulate in water systems. Other sources of pollutants in Neotropical regions experience large inputs of nutrients with these pollutants resulting in eutrophication of water which consume large quantities of oxygen, resulting in high fish mortality. This dilemma has created a need for the development of targeted detection in complex matrices and remediation of emerging contaminants. We have synthesized carbon nanoparticles from macro algae (Ulva fasciata) by oxidizing the graphitic carbon network under extreme acidic conditions. The resulting material was characterized by STEM, yielding a spherical 12 nm average diameter nanoparticles, which can be fixed into a polysaccharide aerogel synthesized from the same macro algae. Spectrophotometer analyses show a pH dependent fluorescent behavior varying from 450-620 nm in aqueous media. Heavily oxidized edges provide for easy functionalization with enzymes for a more targeted analysis and remediation technique. Given the optical properties of the carbon base nanoparticles and the numerous possibilities of functionalization, we have developed a selective and robust targeted bio-detection and bioremediation technique for the treatment of emerging contaminants in complex matrices like estuarine embayment.Keywords: aerogels, carbon nanoparticles, fluorescent, targeted analysis
Procedia PDF Downloads 243610 Transperineal Repair Is Ideal for the Management of Rectocele with Faecal Incontinence
Authors: Tia Morosin, Marie Shella De Robles
Abstract:
Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair
Procedia PDF Downloads 127609 Comparative Scanning Electron Microscopic Observations of Anthelminthic Effect of Trigonella foenum-graecum on Paramphistomum cervi in Buffalo
Authors: Kiran Roat, Bhanupriya Sanger, Gayatri Swarnakar
Abstract:
Amphistomiasis disease is the main health problem throughout of the world and responsible for great economic losses to cattle industries, mostly to poor cattle farmers in developing countries. Among the rumen parasites, the Paramphistomum cervi were collected from the rumen of freshly slaughtered buffalo for the further treatment process. Trigonella foenum-graecum is commonly known as methi and fenugreek and their seeds are known for their therapeutic value. The present study was considered to evaluate in vitro efficacy of aqueous extract of Trigonella foenum-graecum on P. cervi. 130 mg/ml concentration of aqueous extract shows total mortality of P. cervi at 5 hours. The ultrastructural surface topography of untreated animal was compared with a treated animal by scanning electron microscope (SEM). The body of untreated P. cervi in conical shape, tegumental surface is highly ridged with transverse folds and present abundance number of papillaes. Observations demonstrated that the body of treated P. cervi become shrunken & elongated. Treated parasite shows the deep breakage in tegument and the disappearance of tegumental folds & papillae. Severe blebs formations have been found. Above findings, it can be concluded that the seeds of Trigonella foenum-graecum can be used as an anthelminthic agent to eliminate P. cervi from the body of buffalo.Keywords: Paramphistomum cervi, Trigonella foenum-graecum, scanning electron microscope, buffalo
Procedia PDF Downloads 241608 Analyzing the Impact of Migration on HIV and AIDS Incidence Cases in Malaysia
Authors: Ofosuhene O. Apenteng, Noor Azina Ismail
Abstract:
The human immunodeficiency virus (HIV) that causes acquired immune deficiency syndrome (AIDS) remains a global cause of morbidity and mortality. It has caused panic since its emergence. Relationships between migration and HIV/AIDS have become complex. In the absence of prospectively designed studies, dynamic mathematical models that take into account the migration movement which will give very useful information. We have explored the utility of mathematical models in understanding transmission dynamics of HIV and AIDS and in assessing the magnitude of how migration has impact on the disease. The model was calibrated to HIV and AIDS incidence data from Malaysia Ministry of Health from the period of 1986 to 2011 using Bayesian analysis with combination of Markov chain Monte Carlo method (MCMC) approach to estimate the model parameters. From the estimated parameters, the estimated basic reproduction number was 22.5812. The rate at which the susceptible individual moved to HIV compartment has the highest sensitivity value which is more significant as compared to the remaining parameters. Thus, the disease becomes unstable. This is a big concern and not good indicator from the public health point of view since the aim is to stabilize the epidemic at the disease-free equilibrium. However, these results suggest that the government as a policy maker should make further efforts to curb illegal activities performed by migrants. It is shown that our models reflect considerably the dynamic behavior of the HIV/AIDS epidemic in Malaysia and eventually could be used strategically for other countries.Keywords: epidemic model, reproduction number, HIV, MCMC, parameter estimation
Procedia PDF Downloads 366607 Experimental and Computational Investigations on the Mitigation of Air Pollutants Using Pulsed Radio Waves
Authors: Gangadhara Siva Naga Venkata Krishna Satya Narayana Swamy Undi
Abstract:
Particulate matter (PM) pollution in ambient air is a major environmental health risk factor contributing to disease and mortality worldwide. Current air pollution control methods have limitations in reducing real-world ambient PM levels. This study demonstrates the efficacy of using pulsed radio wave technology as a distinct approach to lower outdoor particulate pollution. Experimental data were compared with computational models to evaluate the efficiency of pulsed waves in coagulating and settling PM. Results showed 50%+ reductions in PM2.5 and PM10 concentrations at the city scale, with particle removal rates exceeding gravity settling by over 3X. Historical air quality data further validated the significant PM reductions achieved in test cases. Computational analyses revealed the underlying coagulation mechanisms induced by the pulsed waves, supporting the feasibility of this strategy for ambient particulate control. The pulsed electromagnetic technology displayed robustness in sustainably managing PM levels across diverse urban and industrial environments. Findings highlight the promise of this advanced approach as a next-generation solution to mitigate particulate air pollution and associated health burdens globally. The technology's scalability and energy efficiency can help address a key gap in current efforts to improve ambient air quality.Keywords: particulate matter, mitigation technologies, clean air, ambient air pollution
Procedia PDF Downloads 50606 Association between Hypertensive Disorders of Pregnancy and the Development of Offspring Mental and Behavioural Problems: Systematic Review and Meta-Analysis
Authors: Berihun Dachew, Abdullah Mamun, Joemer Maravilla, Rosa Alati
Abstract:
Background: Hypertensive disorders of pregnancy are a major cause of maternal and childhood morbidity and mortality worldwide. However, its effect on offspring mental and behavioural disorders is unclear. Aims:The aim of this study was to provide the best scientific evidence regarding the association between hypertensive disorders of pregnancy and offspring mental and behavioural problems. Methods: We systematically searched Scopus, PubMed, Cochrane, EMBASE, CINAH and PsycINFO databases. A total of 23 studies (11 included in meta-analysis) were identified. A qualitative analysis was conducted by summarizing, comparing, and contrasting the abstracted data for all included studies. For quantitative analysis, relative risk (RR) with 95% confidence interval (95% CI) was used as pooled effect size. Heterogeneity was assessed by measuring Cochran’s Q and I2 test statistics. Results: Of the 23 studies included in this review, 15 studies found that hypertensive disorders of pregnancy had a negative impact for at least one mental or behavioural problem. The pooled effect of 11 studies included in the meta-analysis showed that preeclampsia was associated with increased risk of offspring schizophrenia (RR=1.37; 95% CI, 1.08-1.72). Conclusions: Intrauterine exposure to pre-eclampsia increased the risk of schizophrenia among offspring. However, we found inconclusive finding on the effect of hypertensive disorders of pregnancy and other mental and behavioural problems. Further high quality, large sample, mother child cohort studies are needed to further progress this area of research.Keywords: behavioural disorders, hypertensive disorders of pregnancy, mental disorders, offspring
Procedia PDF Downloads 238605 Antiplatelet Activity of Nitrated Fatty Acids from Different Food Sources
Authors: Lyanne Rodriguez, Eduardo Fuentes, Andrés Trostchansky, Felipe Lagos
Abstract:
Nutrition is a crucial strategy to combat cardiovascular diseases (CVD), which remain a leading global cause of mortality. Various studies have demonstrated the antiplatelet properties of commonly consumed fruit and vegetable extracts, particularly tomato and bean extracts. Previous research has indicated potent antiplatelet activity in tomato and common bean pomace, attributed to their high fatty acid content (>30%). Notably, fatty acids can undergo nitration during digestion, catalyzed by the reaction of nitrogen dioxide with unsaturated fatty acids. Understanding the mechanisms underlying the formation of nitrated fatty acids from dietary sources is essential to comprehending their antiplatelet action. This research aims to evaluate the formation of nitrated fatty acids (NO₂-FA) from different foods (tomato pulp and common beans). Specifically, tomato pomace and nitrated bean extracts exhibited concentration-dependent antiplatelet effects when platelets were stimulated with TRAP-6 and collagen (1.18±0.04 and 0.7±0.02 mg/mL, respectively). Furthermore, the antiplatelet potential was associated with the modulation of platelet activation markers, as both nitrated extracts suppressed p-selectin expression, CD63 secretion, and fibrinogen modulation. Additionally, a synergistic effect was observed between both nitrated extracts. Our results suggest that NO₂-FA obtained from different food sources has a promising antiplatelet effect for preventing and treating blood clots. This study adds value to these foods in terms of reducing cardiovascular events.Keywords: foods, nitrated fatty acids, nitration, platelets
Procedia PDF Downloads 41604 Isolation, Screening and Identification of Frog Cutaneous Bacteria for Anti-Batrachochytrium dendrobatidis Activity
Authors: Adria Rae Abigail R. Eda, Arvin C. Diesmos, Vance T. Vredenburg, Merab A. Chan
Abstract:
Mitigating strategies using symbiotic cutaneous bacteria is one of the major concerns in the conservation of amphibian population. Batrachochytrium dendrobatidis is the causative agent of chytridiomycosis associated with mass mortality and amphibian extinctions worldwide. In the Philippines, there is a lack of study on the cutaneous bacteria of Philippine amphibians that may have beneficial effects to ward off the deadly fungal infection. In this study, cutaneous bacteria from frogs were isolated and examined for anti-B. dendrobatidis activity. Eight species of frogs were collected at Mt. Palay-palay Mataas na Gulod National Park in Cavite, a site positive for the presence of B. dendrobatidis. Bacteria were isolated from the skin of frogs by swabbing the surfaces of the body and inoculated in Reasoner´s 2A (R2A) agar. Isolated bacteria were tested for potential inhibitory properties against B. dendrobatidis through zoospore inhibition assay. Results showed that frog cutaneous bacteria significantly inhibited the growth of B. dendrobatidis in vitro. By means of 16S rRNA gene primers, the anti-B. dendrobatidis bacteria were identified to be Enterobacter sp., Alcaligenes faecalis and Pseudomonas sp. Cutaneous bacteria namely Enterobacter sp. (isolates PLd33 and PCv4) and Pseudomonas (isolate PLd31) remarkably cleared the growth of B. dendrobatidis zoospore in 1% tryptone agar. Therefore, frog cutaneous bacteria inhibited B. dendrobatidis in vitro and could possibly contribute to the immunity and defense of frogs against the lethal chytridiomycosis.Keywords: Batrachochytrium dendrobatidis, cutaneous bacteria, frogs, zoospore inhibition assay
Procedia PDF Downloads 454603 Glutharaldyde Free Processing of Patch for Cardiovascular Repair Is Associated with Improved Outcomes on Rvot Repair, Rat Model
Authors: Parnaz Boodagh, Danila Vella, Antonio Damore, Laura Modica De Mohac, Sang-Ho Ye, Garret Coyan, Gaetano Burriesci, William Wagner, Federica Cosentino
Abstract:
The use of cardiac patches is among the main therapeutic solution for cardiovascular diseases, a leading mortality cause in the world with an increasing trend, responsible of 19 millions deaths in 2020. Several classes of biomaterials serve that purpose, both of synthetic origin and biological derivation, and many bioengineered treatment alternatives were proposed to satisfy two main requirements, providing structural support and promoting tissue remodeling. The objective of this paper is to compare the mechanical properties and the characterization of four cardiac patches: the Adeka, PhotoFix, CorPatch, and CardioCel patches. In vitro and in vivo tests included: biaxial, uniaxial, ball burst, suture retention for mechanical characterization; 2D surface topography, 3D volume and microstructure, and histology assessments for structure characterization; in vitro test to evaluate platelet deposition, calcium deposition, and macrophage polarization; rat right ventricular outflow tract (RVOT) models at 8- and 16-week time points to characterize the patch-host interaction. Lastly, the four patches were used to produce four stented aortic valve prosthesis, subjected to hydrodynamic assessment as well as durability testing to verify compliance with the standard ISO.Keywords: cardiac patch, cardiovascular disease, cardiac repair, blood contact biomaterial
Procedia PDF Downloads 153602 Activity Anti-Motility Exstract Kedondong Leaf in Balb/C Strain Male Mice Invivo
Authors: Muhammad Abdul Latif, Edijanti Goenarwo , Intan Rahmania Eka
Abstract:
Diarrhea is one of the leading causes of morbidity and mortality in many countries, as well as responsible for the deaths of millions of people each year. Previous research showed that the leaves, bark, and root bark of kedondong contains saponins, tannins, and flavonoids. Tannins have anti-diarrheal effects that work as the freeze of protein / astrigen, and may inhibit the secretion of chloride over the tannate bonding between protein in the intestines. Chemical compounds of flavonoids also have an effect as anti-diarrheal block receptors Cl ˉ in intestinal thus reducing the secretion of Cl ˉ to the intestinal lume. This research aims to know the anti-diarrheal activity of extracts kedondong leaf in mice Balb/C strain males in vivo. This research also proves kedondong leaves as an anti-diarrhea through trial efficacy of kedondong leaves as antisekretori and antimotilitas. This research using post-test only controlled group design. Analysis of statistical data normality and homogenity were tested by Kolmogorov Smirnov. If the data obtained homogenous then using ANOVA test. This research using ethanolic extracts kedondong leaf 200, 400 and 800 mg/kg BW to prove there is anti-motility became five treatment groups. The result showed dose of ethanolic extracts kedondong leaf 800 mg/kg BW have significant value (p < 0.005). The conclusion from this extracts kedondong leaf research 800 mg/kg BW have pharmacological effects as antimotility on Balb/C strain male mice.Keywords: anti-diarrhea, anti-motility, castrol oil, kedondong leaf
Procedia PDF Downloads 475601 A Convolutional Neural Network-Based Model for Lassa fever Virus Prediction Using Patient Blood Smear Image
Authors: A. M. John-Otumu, M. M. Rahman, M. C. Onuoha, E. P. Ojonugwa
Abstract:
A Convolutional Neural Network (CNN) model for predicting Lassa fever was built using Python 3.8.0 programming language, alongside Keras 2.2.4 and TensorFlow 2.6.1 libraries as the development environment in order to reduce the current high risk of Lassa fever in West Africa, particularly in Nigeria. The study was prompted by some major flaws in existing conventional laboratory equipment for diagnosing Lassa fever (RT-PCR), as well as flaws in AI-based techniques that have been used for probing and prognosis of Lassa fever based on literature. There were 15,679 blood smear microscopic image datasets collected in total. The proposed model was trained on 70% of the dataset and tested on 30% of the microscopic images in avoid overfitting. A 3x3x3 convolution filter was also used in the proposed system to extract features from microscopic images. The proposed CNN-based model had a recall value of 96%, a precision value of 93%, an F1 score of 95%, and an accuracy of 94% in predicting and accurately classifying the images into clean or infected samples. Based on empirical evidence from the results of the literature consulted, the proposed model outperformed other existing AI-based techniques evaluated. If properly deployed, the model will assist physicians, medical laboratory scientists, and patients in making accurate diagnoses for Lassa fever cases, allowing the mortality rate due to the Lassa fever virus to be reduced through sound decision-making.Keywords: artificial intelligence, ANN, blood smear, CNN, deep learning, Lassa fever
Procedia PDF Downloads 120600 Epidemiological Profile of Acute Respiratory Infections Hospitalized in Infants and Children Under 15 Years of Age, Hospital Immaculée, Cayes, Haiti, 2019-2021
Authors: Edna Ariste, Richard Standy Coqmar
Abstract:
Background: Acute respiratory infections are a major public health problem in the world, mainly in vulnerable populations such as newborns, children under five years of age, and the elderly. The objective of this study was to Characterize the cases of acute respiratory infections in infants and under 15 years old hospitalized at the Immaculée Conception Hospital in Cayes from January 1, 2019, to December 31, 2021. Methods: A retrospective descriptive study was conducted on the epidemiology profile of acute respiratory infections hospitalized in the pediatric ward at Immaculée Conception Hospital in Les Cayes from January 2019 to December 2021. The study population consisted of all newborns, infants, and children under 15 years of age diagnosed with respiratory infections at the pediatric service. Data were collected from the hospitalization registers and patient records of this unit. A database was created and used for data collection. Excel and Epi info 7.2 were used for data analysis. Results: A total of 588 cases were identified during the 2019-2021 year. 43.5% (256) were female, and 56.5% (332) were male. The average age was 4, 3. The most affected age group was 1-4 years. The male/female sex ratio was 1.2. The most frequent respiratory infections were respectively pneumonia 44.9%, bronchitis 16.5%, and respiratory distress 10.5%. The mortality rate recorded during this period was 4.4%. Conclusion: Acute respiratory infections are more frequent in young children. It is, therefore, necessary to practice hand hygiene. Reinforce the surveillance of severe acute respiratory infections.Keywords: acute respiratory infections, pediatrics, cayes, haiti
Procedia PDF Downloads 86599 Composition and Acaricidal Activity of Elettaria cardamomum Essential Oil Against Oligonychus afrasiaticus
Authors: Abid Hussain, Muhammad Rizwan-ul-Haq, Hassan Al-Ayedh, Ahmed M. Al-Jabr
Abstract:
Oligonychus afrasiaticus, is an important pest that devastates date palms (Phoenix dactylifera). They caused serious damage to date palm fruits. They start feeding on dates at Kimri stage (greenish color dates with high sugar and moisture level) resulting severe fruit losses and rendering them unfit for human consumption. Currently, acaricides are the only tool available to Saudi growers to prevent O. afrasiaticus damage. Many acaricides are available in the Saudi markets in order to control the mites on date palm trees but their efficacy against O. afrasiaticus is questionable. The intensive use of acaricides has led to resistance in many mite species around the globe and their control becomes exceedingly challenging. The current investigation explored for the first time the acaricidal potential of Elettaria cardamomum essential oil for the environmentally safe management of date mites in the laboratory. E. cardamomum exhibited acaricidal activities in a dose dependent manner. GC-MS fractionation of E. cardamomum detected numerous compounds. Among the identified compounds, Guaniol caused 100% mortality compared to other identified compounds including (+)-α-Pinene, Camphene, (-)-B-Pinene, 3-Carene, (R)-(+)-Limonene, and Citral. Our laboratory results showed that E. cardamomum and its constituents especially Guaniol are promising for the eco-friendly management of date mites, O. afrasiaticus, although their field efficacy remains to be evaluated.Keywords: cardamom, old world date mite, natural acaricide, toxicity
Procedia PDF Downloads 310598 Pattern and Risk Factors of Menstrual Regulation Service Use among Ever-married Women in Bangladesh: Evidence from a Nationally Representative Cross-sectional Study
Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee
Abstract:
Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh
Procedia PDF Downloads 161597 The Effect of Rosella Flower Flour (Hibiscus sabdariffa L.) Utilization in Ration on Performance of Broiler Chicken
Authors: Nurlisa Uke Dessy, Dwi Septian Erwinsyah, Zuprizal
Abstract:
This experiment was aimed to investigate the effect of rosella flower flour in diet on broiler chicken Performace. The materials used in this experiment were 72 broiler chickens and were divided into six treatments, those were R0 = without rosella flower flour addition, R1 = 0.5% rosella flower flour addition, R2 = 1.0% rosella flower flour addition, R3 = 1.5% rosella flower flour addition, R4 = 2.0% rosella flower flour addition, and R5 = 2.5% rosella flower flour addition. Each treatment consisted of three replications and each replication consisted of four broiler chickens. This research took 35 days to collect the data. Parameters measured were feed intake, rosella flower flour consumption, body weight gain, feed conversion and mortality. The collected data were analyzed using Completely Randomized Design (CRD) and the differences of mean were tested by Duncan’s New Multiple Range Test (DMRT). The result showed the average of feed consumption were 2154; 2154; 2034; 2154; 2034 and 2154 g/bird on broiler chicken that were feed respectively by 0.0; 0.5; 1.0; 1.5; 2.0; and 2.5% rosella flower flour level. The average consumptions of rosella flower flour respectively were 0; 10.77; 20.34; 32.31; 40.68; and 53.85 g/bird. The body weight gains were 1263.33±70.40; 1422.42±36.33; 1443.75±30.00; 1387.42± 35.30; 1411.17±29.58 and 1457.08±40.75 g/bird. Feed conversion results were 1.71±0.94; 1.51±0.37; 1.47±0.62; 1.55±0.40; 1.53±0.30 and 1.48±0.40. The conclusion of the experiment was known that using rosella flower flour until 2.5% level in diet was able to increase broiler chicken performance, and also to decrease broiler chicken feed conversion.Keywords: feed intake, consumptions rosella flower flour, broiler chickens, body weight gain, feed conversion
Procedia PDF Downloads 634596 Post Coronary Artery Stenting Reflighting: Need for Change in Policy with Changing Antiplatelet Therapy
Authors: Keshavamurthy Ganapathy Bhat, Manvinderpal Singh Marwaha
Abstract:
Background: Coronary artery Disease (CAD) is a common cause of morbidity, mortality and reason for unfitness amongst aircrew. Coronary angioplasty and stenting are the standard of care for CAD. Antiplatelet drugs like Aspirin and Clopidogrel(Dual Antiplatelet therapy) are routinely prescribed post-stenting which are permitted for flying. However, in the recent past, Ticagrelor is being used in place of Clopidogrel as per ACC AHA and ESC guidelines. However Ticagrelor is not permitted for flying. Case Presentation: A 55-year-old pilot suffered Anterior Wall Myocardial Infarction. Angiography showed blockages in Left Anterior Descending Artery(LAD) and Right coronary artery (RCA). He underwent primary angioplasty and stenting LAD and subsequent stenting to RCA. Recovery was uneventful. One year later he was asymptomatic with normal Left ventricular function and no reversible perfusion defect on stress MPI. He had patent stents and coronaries on check angiogram. However, he was not allowed to fly since he was on Ticagrelor. He had to be switched over to Clopidogrel from Ticagrelor one year after stenting to permit him for flying. Similarly, switching had to be done in a 45-year-old pilot. Ticagrelor has been proven to be more effective than clopidogrel and as safe as Clopidogrel in preventing stent thrombosis. If Clopidogrel is being permitted, there is no need to restrict Ticagrelor. Hence "Policy" needs to be changed. Conclusions: Dual Antiplatelet therapy is the standard of care post coronary stenting which has been proved safe and effective. Policy needs to be changed to permit flying with Ticagrelor which is more effective than Clopidogrel and equally safe.Keywords: antiplatelet drugs, coronary artery disease, stenting, ticagrelor
Procedia PDF Downloads 167595 The Efficacy of Andrographis paniculata and Chromolaena odorata Plant Extract against Malaria Parasite
Authors: Funmilola O. Omoya, Abdul O. Momoh
Abstract:
Malaria constitutes one of the major health problems in Nigeria. One of the reasons attributed for the upsurge was the development of resistance of Plasmodium falciparum and the emergence of multi-resistant strains of the parasite to anti-malaria drugs. A continued search for other effective, safe and cheap plant-based anti-malaria agents thus becomes imperative in the face of these difficulties. The objective of this study is therefore to evaluate the in vivo anti-malarial efficacy of ethanolic extracts of Chromolaena odorata and Androgaphis paniculata leaves. The two plants were evaluated for their anti-malaria efficacy in vivo in a 4-day curative test assay against Plasmodium berghei strain in mice. The group treated with 500mg/ml dose of ethanolic extract of A. paniculata plant showed parasite suppression with increase in Packed Cell Volume (PCV) value except day 3 which showed a slight decrease in PCV value. During the 4-day curative test, an increase in the PCV values, weight measurement and zero count of Plasmodium berghei parasite values was recorded after day 3 of drug administration. These results obtained in group treated with A. paniculata extract showed anti-malarial efficacy with higher mortality rate in parasitaemia count when compared with Chromolaena odorata group. These results justify the use of ethanolic extracts of A. paniculata plant as medicinal herb used in folklore medicine in the treatment of malaria.Keywords: anti-malaria, curative, plant-based anti-malaria agents, biology
Procedia PDF Downloads 298594 Incidence of Post-Stroke Depression in a Tertiary Hospital in Cebu City, Philippines
Authors: Ivory A. Rulona, Jarungchai Anton S. Vatanagul
Abstract:
Background: Depression is common after stroke with quoted rates ranging from 18% to 61%. 8 Mood disturbance is common after stroke and may present as depression or anxiety. Psychological mood disturbance is associated with higher rates of mortality, long term disability, and hospital readmission. Objectives: To investigate the incidence of post-stroke depression in a tertiary hospital in Cebu City, Philippines and to determine its associated factors. The study is designed to be prospective, descriptive, cross-sectional survey. Participants: Adult patients seen and diagnosed to have stroke either infarct or hemorrhage within the period of January 1 to July 31, 2014. Results: A total of 100 patients with stroke were interviewed using the 17-item Hamilton Depression Rating Scale (HDRS) questionnaire. The average age of the respondents was 60.50 years old ±1.18, majority were males (55%), 83% were married, and 81% were employed. The most common co-morbidity was hypertension 78% followed by diabetes mellitus at 50%. Moreover, 39% of these patients had stroke in months, 26% in years, and 18% in weeks. The average functional capacity based on Modified Rankin Scale was 2.14+/-0.14. Among 100 patients, a total of 30 patients (30%) had depression: 2 (2%) very severe, 5 (5%) moderate and 23 (23%) had mild depression while 70 patients (70%) had no depression. Stroke located at the dominant hemisphere was not associated with severe depression (p=0.102). A similar trend was also noted among those with stroke at the right side (p=0.183), pons (p=0.634), bilateral (p=0.776), and midbrain (p=0.336). Conclusion: This study showed that majority of stroke patients were males with average age of 60.50 years. Hypertension was the most common co-morbidity. There was no association between stroke location and depression. The incidence of PSD was 30%.Keywords: post-stroke depression, co-morbidity, disturbance, bilateral
Procedia PDF Downloads 299593 Dietary Effect of Probiotic Bacteria, Bacillus amyloliquefaciens JFP-2 Isolate from Jeju Island`s Traditional Fermented Food, on Innate Immune Response of Oplegnathus fasciatus Challenged with Vibrio anguillarum
Authors: Dong Hwi Kim, Dharaneedharan Subramanian, So Hyun Park, Ha-Ri Choi, Ji-Hyung Kim, Dong-Hoon Lee, Moon Soo Heo
Abstract:
The present study was performed to evaluate the use of Bacillus amyloliquefaciens JFP-2 isolated from a traditional fermented sea food, as probiotic bacteria in the diets for Rock-bream, Oplegnathus faciatus. A total of 180 fish (187.4 ± 2.7 g) were divided into two groups, control (C) and probiotic (P) group (90 fish per group) in triplicate. C group was fed with basal diet without probiotic, while P group was fed with B. amyloliquefaciens spores at concentration of 1.4 x 106 colony forming units per gram (CFU/g) of feed. After two months of feeding experiments, P group fish showed significant improvements in body weight (BW), weight gain (WG), specific growth rate (SGR) and food conversion ratio (FCR) compared with C group. Also, bi-weekly assessment of serum protein, glucose, fatty acid profile showed a significant increase in probiotic fed fish than that of control fish group. Similar increase in serum antioxidant and lysozyme activity was found in probiotic fed fish group. Twenty days challenge experiment shows decrease mortality in probiotic fed fish group when compared with that of control group. Hence, these results indicate that the use of B. amyloliquefaciens JFP-2 as a feed supplement, is beneficial to improve the health status of Oplegnathus fasciatus challenged with Vibrio anguillarum.Keywords: Bacillus amyloliquefaciens, Oplegnathus fasciatus, probiotic feed, rock bream
Procedia PDF Downloads 259592 Factors Associated with Injuries and Trauma Among the Survivors of Gender-Based Violence in Afghanistan
Authors: Mohammad Akbar Paiman, Yasmin Nadeem Parpio, Naureen Akbarali, Khwaja Mir Islam Saeed, Murad Moosa Khan
Abstract:
Background: Gender-based violence (GBV) is widely considered a significant public health problem that is associated with acute morbidity and mortality. GBV is commonly understood as a physical, sexual, and mental assault from intimate partners, sexual violence by non-partners, sexual assault of girls, and acts like trafficking women for sex. Objective: This study aimed to determine the factors associated with injuries and trauma among victims of GBV in Afghanistan. Method: We conducted a record-based analysis of the data collected by the Gender Department of the Family Protection Centre nationally between November 2013 and October 2019. Cross-tabulation between different variables such as age, sex, marital status, and type of violence and associations between different types of violence, age, gender, and geographical location was determined using the logistic regression model. Results: During the study period, there were a total of 58,160 GBV in Afghanistan. Most of the victims were women 98% with over three-quarters being adults 78%. Most of the victims were married 76%, followed by single 14%, widowed 5%, and engaged 5%. Over three-quarters of the violence, 73% was observed in the victim’s house while nearly one-quarter of the violence 24 % occurred in the perpetrator’s house. Conclusions: GBV is a significant public health problem in Afghanistan that needs to be addressed at multiple levels including policy, state, and community as well as by raising public awareness and education and a strong code of conduct against GBV by all stakeholders.Keywords: gender-based violence, physical and psychological violence, injuries, Afghanistan
Procedia PDF Downloads 54591 Molecular Profiles of Microbial Etiologic Agents Forming Biofilm in Urinary Tract Infections of Pregnant Women by RTPCR Assay
Authors: B. Nageshwar Rao
Abstract:
Urinary tract infection (UTI) represents the most commonly acquired bacterial infection worldwide, with substantial morbidity, mortality, and economic burden. The objective of the study is to characterize the microbial profiles of uropathogenic in the obstetric population by RTPCR. Study design: An observational cross-sectional study was performed at a single tertiary health care hospital among 50 pregnant women with UTIs, including asymptomatic and symptomatic patients attending the outpatient department and inpatient department of Obstetrics and Gynaecology.Methods: Serotyping and genes detection of various uropathogens were studied using RTPCR. Pulse filed gel electrophoresis methods were used to determine the various genetic profiles. Results: The present study shows that CsgD protein, involved in biofilm formation in Escherichia coli, VIM1, IMP1 genes for Klebsiella were identified by using the RTPCR method. Our results showed that the prevalence of VIM1 and IMP1 genes and CsgD protein in E.coli showed a significant relationship between strong biofilm formation, and this may be due to the prevalence of specific genes. Finally, the genetic identification of RTPCR results for both bacteria was correlated with each other and concluded that the above uropathogens were common isolates in producing Biofilm in the pregnant woman suffering from urinary tract infection in our hospital observational study.Keywords: biofilms, Klebsiella, E.coli, urinary tract infection
Procedia PDF Downloads 126590 A Sui Generis Technique to Detect Pathogens in Post-Partum Breast Milk Using Image Processing Techniques
Authors: Yogesh Karunakar, Praveen Kandaswamy
Abstract:
Mother’s milk provides the most superior source of nutrition to a child. There is no other substitute to the mother’s milk. Postpartum secretions like breast milk can be analyzed on the go for testing the presence of any harmful pathogen before a mother can feed the child or donate the milk for the milk bank. Since breast feeding is one of the main causes for transmission of diseases to the newborn, it is mandatory to test the secretions. In this paper, we describe the detection of pathogens like E-coli, Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), Hepatitis C (HCV), Cytomegalovirus (CMV), Zika and Ebola virus through an innovative method, in which we are developing a unique chip for testing the mother’s milk sample. The chip will contain an antibody specific to the target pathogen that will show a color change if there are enough pathogens present in the fluid that will be considered dangerous. A smart-phone camera will then be acquiring the image of the strip and using various image processing techniques we will detect the color development due to antigen antibody interaction within 5 minutes, thereby not adding to any delay, before the newborn is fed or prior to the collection of the milk for the milk bank. If the target pathogen comes positive through this method, then the health care provider can provide adequate treatment to bring down the number of pathogens. This will reduce the postpartum related mortality and morbidity which arises due to feeding infectious breast milk to own child.Keywords: postpartum, fluids, camera, HIV, HCV, CMV, Zika, Ebola, smart-phones, breast milk, pathogens, image processing techniques
Procedia PDF Downloads 222589 Comparative Study of the Sensitivity of Two Freshwater Gastropods, Lymnaea Stagnalis and Planorbarius Corneus, to Silver Nanoparticles: Bioaccumulation and Toxicity
Authors: Ting Wang, Pierre Marle, Vera I. Slaveykova, Kristin Schirmer, Wei Liu
Abstract:
Metal-based nanoparticles (NPs) are considered detrimental to aquatic organisms due to their potential accumulation. However, little is known about the mechanisms underlying these effects and their species-specificity. Here, we used stable silver (Ag) NPs (20 nm, from 10 to 500 μg/L) with a low dissolution rate (≤2.4%) to study the bioaccumulation and biological impacts in two freshwater gastropods: Lymnaea stagnalis and Planorbarius corneus. No mortality was detected during the experiments. Ag bioaccumulation showed a dose-related increase with an enhanced concentration in both species after 7d exposure. L. stagnalis displayed a higher accumulation for AgNPs than P. corneus (e.g., up to 18- and 15-fold in hepatopancreas and hemolymph, respectively), which could be due to the more active L. stagnalis having greater contact with suspended AgNPs. Furthermore, the hepatopancreas and stomach were preferred organs for bioaccumulation compared to the kidney, mantle and foot. Regarding biological responses, the hemolymph rather than hepatopancreas appeared more susceptible to oxidative stress elicited by AgNPs, as shown by significantly increasing lipid peroxidation (i.e., formation of malondialdehyde). Neurotoxicity was detected in L. stagnalis when exposed to high concentrations (500 μg/L). Comparison with impacts elicited by dissolved Ag revealed that the effects observed on AgNPs exposure were mainly attributable to NPs. These results highlighted the relationship between the physiological traits, bioaccumulation, and toxicity responses of these two species to AgNPs and demonstrated the necessity of species-specificity considerations when assessing the toxicity of NPs.Keywords: nanotoxicity, freshwater gastropods, species-specificity, metals, physiological traits
Procedia PDF Downloads 63588 Epidemiological and Clinical Profile of Patients with Chorioamnionitis
Authors: Isabel Cristina Ortiz Trujillo, Lina Maria Martinez Sanchez, Felipe Hernández Restrepo, Daniel Gallego Gonzalez, Natalia Vargas Grisales, Camilo Andrés Agudelo Vélez
Abstract:
Chorioamnionitis, is a pregnancy infection, causes different fetal and maternal symptoms. Streptococcus agalactiae present in the normal vaginal microflora of some women, favouring its abnormal multiplication during pregnancy, causing perinatal morbidity and mortality. Objective. Describe the clinical and epidemiological profile of the patients with diagnosis of clinical chorioanmionitis. Methodology. Descriptive, cross-sectional study. The population was patients with diagnosis of clinical chorioanmionitis. The information was taken from the medical records. The research was approved by the Ethics Committee. We used the program SPSS ® version 17.0 (SPSS Inc; Chicago, Illinois, USA) for the information analysis, descriptive statistics were used. Results. 78 patients in total with clinical chorioamnionitis, with a mean age of 26.3 ±5, 8 years old, the 69.2% primigravid women. 2.6% of women had positive culture for Streptococcus agalactiae in urine sample during current pregnancy and 30.7% had received some kind of antibiotics during current pregnancy. The 57.7% had 37 to 40 weeks of gestation in the current pregnancy it was calculated more frequently by ultrasound (66.7% in first quarter, 11.5% in the second and 1.9% in the third). In a 60.3% way of termination of pregnancy was vaginal and a 35.9 percent were caesarean section. Among the women in the study, a 30.8% had premature rupture of membranes. Conclusion. The chorioamnionitis continues to be an important cause of antibiotic use during pregnancy or labour and the decision to do a caesarean, with highest percentage in pregnancies-preterm and preterm premature rupture of membranes.Keywords: chorioamnionitis, Streptococcus agalactiae, pregnancy complications, infectious
Procedia PDF Downloads 422