Search results for: peripheral nerve regeneration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1082

Search results for: peripheral nerve regeneration

392 Prognostic Implication of Nras Gene Mutations in Egyptian Adult Acute Myeloid Leukemia

Authors: Doaa M. Elghannam, Nashwa Khayrat Abousamra, Doaa A. Shahin, Enas F. Goda, Hanan Azzam, Emad Azmy, Manal Salah El-Din

Abstract:

Background: The pathogenesis of acute myeloid leukemia (AML) involves the cooperation of mutations promoting proliferation/survival and those impairing differentiation. Point mutations of the NRAS gene are the most frequent somatic mutations causing aberrant signal-transduction in acute myeloid leukemia (AML). Aim: The present work was conducted to study the frequency and prognostic significance of NRAS gene mutations (NRASmut) in de novo Egyptian adult AML. Material and methods: Bone marrow specimens from 150 patients with de novo acute myeloid leukemia and controls were analyzed by genomic PCR-SSCP at codons 12, 13 (exon 1), and 61 (exon 2) for NRAS mutations. Results: NRAS gene mutations was found in 19/150 (12.7%) AML cases, represented more frequently in the FAB subtype M4eo (P = 0.028), and at codon 12, 13 (14of 19; 73.7%). Patients with NRASmut had a significant lower peripheral marrow blasts (P = 0.004, P=0.03) and non significant improved clinical outcome than patients without the mutation. Complete remission rate was (63.2% vs 56.5%; p=0.46), resistant disease (15.8% vs 23.6%; p=0.51), three years overall survival (44% vs 42%; P = 0.85) and disease free survival (42.1% vs 38.9%, P = 0.74). Multivariate analysis showed that age was the strongest unfavorable factor for overall survival (relative risk [RR], 1.9; P = .002), followed by cytogenetics (P = .004). FAB types, NRAS mutation, and leukocytosis were less important. Conclusions: NRAS gene mutation frequency and spectrum differ between biologically distinct subtypes of AML but do not significantly influence prognosis and clinical outcome.

Keywords: NRAS Gene, egyptian adult, acute myeloid leukemia, cytogenetics

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391 Removal of Cr (VI) from Water through Adsorption Process Using GO/PVA as Nanosorbent

Authors: Syed Hadi Hasan, Devendra Kumar Singh, Viyaj Kumar

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Cr (VI) is a known toxic heavy metal and has been considered as a priority pollutant in water. The effluent of various industries including electroplating, anodizing baths, leather tanning, steel industries and chromium based catalyst are the major source of Cr (VI) contamination in the aquatic environment. Cr (VI) show high mobility in the environment and can easily penetrate cell membrane of the living tissues to exert noxious effects. The Cr (VI) contamination in drinking water causes various hazardous health effects to the human health such as cancer, skin and stomach irritation or ulceration, dermatitis, damage to liver, kidney circulation and nerve tissue damage. Herein, an attempt has been done to develop an efficient adsorbent for the removal of Cr (VI) from water. For this purpose nanosorbent composed of polyvinyl alcohol functionalized graphene oxide (GO/PVA) was prepared. Thus, obtained GO/PVA was characterized through FTIR, XRD, SEM, and Raman Spectroscopy. As prepared nanosorbent of GO/PVA was utilized for the removal Cr (VI) in batch mode experiment. The process variables such as contact time, initial Cr (VI) concentration, pH, and temperature were optimized. The maximum 99.8 % removal of Cr (VI) was achieved at initial Cr (VI) concentration 60 mg/L, pH 2, temperature 35 °C and equilibrium was achieved within 50 min. The two widely used isotherm models viz. Langmuir and Freundlich were analyzed using linear correlation coefficient (R2) and it was found that Langmuir model gives best fit with high value of R2 for the data of present adsorption system which indicate the monolayer adsorption of Cr (VI) on the GO/PVA. Kinetic studies were also conducted using pseudo-first order and pseudo-second order models and it was observed that chemosorptive pseudo-second order model described the kinetics of current adsorption system in better way with high value of correlation coefficient. Thermodynamic studies were also conducted and results showed that the adsorption was spontaneous and endothermic in nature.

Keywords: adsorption, GO/PVA, isotherm, kinetics, nanosorbent, thermodynamics

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390 Bacterial Cellulose/Silver-Doped Hydroxyapatite Composites for Tissue Engineering Application

Authors: Adrian Ionut Nicoara, Denisa Ionela Ene, Alina Maria Holban, Cristina Busuioc

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At present, the development of materials with biomedical applications is a domain of interest that will produce a full series of benefits in engineering and medicine. In this sense, it is required to use a natural material, and this paper is focused on the development of a composite material based on bacterial cellulose – hydroxyapatite and silver nanoparticles with applications in hard tissue. Bacterial cellulose own features like biocompatibility, non-toxicity character and flexibility. Moreover, the bacterial cellulose can be conjugated with different forms of active silver to possess antimicrobial activity. Hydroxyapatite is well known that can mimic at a significant level the activity of the initial bone. The material was synthesized by using an ultrasound probe and finally characterized by several methods. Thereby, the morphological properties were analyzed by using Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM). Because the synthesized material has medical application in restore the tissue and to fight against microbial invasion, the samples were tested from the biological point of view by evaluating the biodegradability in phosphate-buffered saline (PBS) and simulated body fluid (SBF) and moreover the antimicrobial effect was performed on Gram-positive bacterium Staphylococcus aureus, Gram-negative bacterium Escherichia coli, and fungi Candida albicans. The results reveal that the obtained material has specific characteristics for bone regeneration.

Keywords: bacterial cellulose, biomaterials, hydroxyapatite, scaffolds materials

Procedia PDF Downloads 113
389 Assessment of Isatin as Surface Recognition Group: Design, Synthesis and Anticancer Evaluation of Hydroxamates as Novel Histone Deacetylase Inhibitors

Authors: Harish Rajak, Kamlesh Raghuwanshi

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Histone deacetylase (HDAC) are promising target for cancer treatment. The panobinostat (Farydak; Novartis; approved by USFDA in 2015) and chidamide (Epidaza; Chipscreen Biosciences; approved by China FDA in 2014) are the novel HDAC inhibitors ratified for the treatment of patients with multiple myeloma and peripheral T cell lymphoma, respectively. On the other hand, two other HDAC inhibitors, Vorinostat (SAHA; approved by USFDA in 2006) and Romidepsin (FK228; approved by USFDA in 2009) are already in market for the treatment of cutaneous T-cell lymphoma. Several hydroxamic acid based HDAC inhibitors i.e., belinostat, givinostat, PCI24781 and JNJ26481585 are in clinical trials. HDAC inhibitors consist of three pharmacophoric features - an aromatic cap group, zinc binding group (ZBG) and a linker chain connecting cap group to ZBG. Herein, we report synthesis, characterization and biological evaluation of HDAC inhibitors possessing substituted isatin moiety as cap group which recognize the surface of active enzyme pocket and thiosemicarbazide moiety incorporated as linker group responsible for connecting cap group to ZBG (hydroxamic acid). Several analogues were found to inhibit HDAC and cellular proliferation of Hela cervical cancer cells with GI50 values in the micro molar range. Some of the compounds exhibited promising results in vitro antiproliferative studies. Attempts were also made to establish the structure activity relationship among synthesized HDAC inhibitors.

Keywords: HDAC inhibitors, hydroxamic acid derivatives, isatin derivatives, antiproliferative activity, docking

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388 Study on the Spatial Evolution Characteristics of Urban Agglomeration Integration in China: The Case of Chengdu-Chongqing Urban Agglomeration

Authors: Guoqin Ge, Minhui Huang, Yazhou Zhou

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The growth of the Chengdu-Chongqing urban agglomeration has been designated as a national strategy in China. Analyzing its spatial evolution characteristics is crucial for devising relevant development strategies. This paper enhances the gravitational model by using temporal distance as a factor. It applies this improved model to assess the economic interconnection and concentration level of each geographical unit within the Chengdu-Chongqing urban agglomeration between 2011 and 2019. On this basis, this paper examines the spatial correlation characteristics of economic agglomeration intensity and urban-rural development equalization by employing spatial autocorrelation analysis. The study findings indicate that the spatial integration in the Chengdu-Chongqing urban agglomeration is currently in the "point-axis" development stage. The spatial organization structure is becoming more flattened, and there is a stronger economic connection between the core of the urban agglomeration and the peripheral areas. The integration of the Chengdu-Chongqing urban agglomeration is currently hindered by conflicting interests and institutional heterogeneity between Chengdu and Chongqing. Additionally, the connections between the relatively secondary spatial units are largely loose and weak. The strength and scale of economic ties and the level of urban-rural equilibrium among spatial units within the Chengdu-Chongqing urban agglomeration have increased, but regional imbalances have continued to widen, and such positive and negative changes have been characterized by the spatial and temporal synergistic evolution of the "core-periphery". Ultimately, this paper presents planning ideas for the future integration development of the Chengdu-Chongqing urban agglomeration, drawing from the findings.

Keywords: integration, planning strategy, space organization, space evolution, urban agglomeration

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387 Monte Carlo Simulation of X-Ray Spectra in Diagnostic Radiology and Mammography Using MCNP4C

Authors: Sahar Heidary, Ramin Ghasemi Shayan

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The overall goal Monte Carlo N-atom radioactivity transference PC program (MCNP4C) was done for the regeneration of x-ray groups in diagnostic radiology and mammography. The electrons were transported till they slow down and stopover in the target. Both bremsstrahlung and characteristic x-ray creation were measured in this study. In this issue, the x-ray spectra forecast by several computational models recycled in the diagnostic radiology and mammography energy kind have been calculated by appraisal with dignified spectra and their outcome on the scheming of absorbed dose and effective dose (ED) told to the adult ORNL hermaphroditic phantom quantified. This comprises practical models (TASMIP and MASMIP), semi-practical models (X-rayb&m, X-raytbc, XCOMP, IPEM, Tucker et al., and Blough et al.), and Monte Carlo modeling (EGS4, ITS3.0, and MCNP4C). Images got consuming synchrotron radiation (SR) and both screen-film and the CR system were related with images of the similar trials attained with digital mammography equipment. In sight of the worthy feature of the effects gained, the CR system was used in two mammographic inspections with SR. For separately mammography unit, the capability acquiesced bilateral mediolateral oblique (MLO) and craniocaudal(CC) mammograms attained in a woman with fatty breasts and a woman with dense breasts. Referees planned the common groups and definite absences that managed to a choice to miscarry the part that formed the scientific imaginings.

Keywords: mammography, monte carlo, effective dose, radiology

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386 Cultural Artifact, Sign Language and Perspectives of Meaning in Select-Nollywood Films

Authors: Aniekan James Akpan

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The use of signs and symbols to represent cardinal information is inalienable among African communities. It has been the tenable instrument of cultural transmission for decades, but in the current transposal of Western values, a good number of communicating codes and symbolic images have been gradually relegated to the background. This paper discusses the regeneration of cultural artifacts and sign languages in Nigerian films using Johnpaul Rebecca and Ayamma as models in a qualitative research based on Charles Sanders Pierce's Semiotics as well as quantitative methods of survey using questionnaire and focus group discussion as instruments to obtain data. With a population of 2,343 viewers of the movies used for the study and a sample size of 322 respondents using Philip Meyer’s guide, findings show that cultural relics can stabilise the subject matter of a film. Artifacts can stimulate curiosity and invoke nostalgia. Sign languages encode deeper information that ordinary speech may not properly convey in films. It concludes that the use of non-verbal codes in filmmaking deserves deep research into the culture portrayed and that non-verbal cues communicate deeper information about a people's cosmos in a film than dialogue. It recommends that adequate research should be made before producing a film and the idea of cultural values represented in artifacts and sign language should be ingrained in the courses for students to acquaint themselves with.

Keywords: cultural artifact, Nollywood films, non-verbal communication, sign language

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385 Development and Characterization of Soya Phosphatidylcholine Complex of Coumestans from Eclipta alba for the Management of Hepatotoxicity

Authors: Abhishek Kumar Jain, Anki Jain, Yuvraj Singh Dangi, Brajesh Kumar Tiwari

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The plant Eclipta alba Hassk. (Family: Compositae) contains coumestans (wedelolactone and demethyl wedelolactone) used in liver disorders. The objective of the present investigation was to develop a formulation of these coumestans in combination with the soya phosphatidylcholine (PC), in order to overcome the limitation of absorption and to investigate the protective effect of coumestans–phosphatidylcholine complex (C-PC) on carbon tetrachloride induced acute liver damage in rats. Methanolic extract (ME) of the whole plant of Eclipta alba was fractionated with water and then with ehylacetate. Coumestans were characterized in the ethylacetate fraction of methanolic extract (EFME). The C-PC was prepared by dissolving EFME and PC in 1:1 ratio in dichloromethane and heating at 60°C for 2 h. The C-PC was characterized by DSC and FTIR spectroscopy. In vitro drug release from EFME and C-PC through egg membrane was measured using UV-Visible spectrophotometer. The hepatoprotective activity of C-PC (equivalent to 5.35 and 10.7 mg/kg body weight of EFME), ME 250 mg/kg and EFME 5.35 mg/kg was evaluated by measuring various enzymes level. C-PC significantly provided better protection to the liver by restoring the enzyme levels of SGPT, SGOT, ALP and total billirubin with respect to carbon tetrachloride (CCl4) treated group (P < 0.001). Histopathological studies were also performed. The C-PC provided better protection to rat liver than ME and EFME at similar doses as well as shown significant regeneration of hepatocytes, central vein, intact cytoplasm, and nucleus.

Keywords: hepatotoxicity, wedelolactone, soya phosphatidylcholine, eclipta alba

Procedia PDF Downloads 384
384 Analgesic Efficacy of IPACK Block in Primary Total Knee Arthroplasty (90 CASES)

Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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 Background and aims: Peripheral regional anesthesia has been integrated into most analgesia protocols for total knee arthroplasty which considered among the most painful surgeries with a huge potential for chronicization. The adductor canal block (ACB) has gained popularity. Similarly, the IPACK block has been described to provide analgesia of the posterior knee capsule. This study aimed to evaluate the analgesic efficacy of this block in patients undergoing primary PTG. Methods: 90 patients were randomized to receive either an IPACK, an anterior sciatic block, or a sham block (30 patients in each group + multimodal analgesia and a catheter in the KCA adductor canal). GROUP 1 KCA GROUP 2 KCA+BSA GROUP 3 KCA+IPACK The analgesic blocks were done under echo-guidance preoperatively respecting the safety rules, the dose administered was 20 cc of ropivacaine 0.25% was used. We were to assess posterior knee pain 6 hours after surgery. Other endpoints included quality of recovery after surgery, pain scores, opioid requirements (PCA morphine)(EPI info 7.2 analysis). Results: -groups were matched -A predominance of women (4F/1H). -average age: 68 +/-7 years -the average BMI =31.75 kg/m2 +/- 4. -70% of patients ASA2 ,20% ASA3. -The average duration of the intervention: 89 +/- 19 minutes. -Morphine consumption (PCA) significantly higher in group 1 (16mg) & group 2 (8mg) group 3 (4mg) - The groups were matched . -There was a correlation between the use of the ipack block and postoperative pain Conclusions :In a multimodal analgesic protocol, the addition of IPACK block decreased pain scores and morphine consumption ,

Keywords: regional anesthesia, analgesia, total knee arthroplasty, the adductor canal block (acb), the ipack block, pain

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383 Tandem Concentrated Photovoltaic-Thermoelectric Hybrid System: Feasibility Analysis and Performance Enhancement Through Material Assessment Methodology

Authors: Shuwen Hu, Yuancheng Lou, Dongxu Ji

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Photovoltaic (PV) power generation, as one of the most commercialized methods to utilize solar power, can only convert a limited range of solar spectrum into electricity, whereas the majority of the solar energy is dissipated as heat. To address this problem, thermoelectric (TE) module is often integrated with the concentrated PV module for waste heat recovery and regeneration. In this research, a feasibility analysis is conducted for the tandem concentrated photovoltaic-thermoelectric (CPV-TE) hybrid system considering various operational parameters as well as TE material properties. Furthermore, the power output density of the CPV-TE hybrid system is maximized by selecting the optimal TE material with application of a systematic assessment methodology. In the feasibility analysis, CPV-TE is found to be more advantageous than sole CPV system except under high optical concentration ratio with low cold side convective coefficient. It is also shown that the effects of the TE material properties, including Seebeck coefficient, thermal conductivity, and electrical resistivity, on the feasibility of CPV-TE are interacted with each other and might have opposite effect on the system performance under different operational conditions. In addition, the optimal TE material selected by the proposed assessment methodology can improve the system power output density by 227 W/m2 under highly concentrated solar irradiance hence broaden the feasible range of CPV-TE considering optical concentration ratio.

Keywords: feasibility analysis, material assessment methodology, photovoltaic waste heat recovery, tandem photovoltaic-thermoelectric

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382 The Evaluation of Superiority of Foot Local Anesthesia Method in Dairy Cows

Authors: Samaneh Yavari, Christiane Pferrer, Elisabeth Engelke, Alexander Starke, Juergen Rehage

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Background: Nowadays, bovine limb interventions, especially any claw surgeries, raises selection of the most qualified and appropriate local anesthesia technique applicable for any superficial or deep interventions of the limbs. Currently, two local anesthesia methods of Intravenous Regional Anesthesia (IVRA), as well as Nerve Blocks, have been routine to apply. However, the lack of studies investigating the quality and duration as well as quantity and onset of full (complete) local anesthesia, is noticeable. Therefore, the aim of our study was comparing the onset and quality of both IVRA and our modified NBA at the hind limb of dairy cows. For this abstract, only the onset of full local anesthesia would be consider. Materials and Methods: For that reason, we used six healthy non pregnant non lactating Holestein Frisian cows in a cross-over study design. Those cows divided into two groups to receive IVRA and our modified four-point NBA. For IVRA, 20 ml procaine without epinephrine was injected into the vein digitalis dorsalis communis III and for our modified four-point NBA, 10-15 ml procaine without epinephrine preneurally to the nerves, superficial and deep peroneal as well as lateral and medial branches of metatarsal nerves. For pain stimulation, electrical stimulator Grass S48 was applied. Results: The results of electrical stimuli revealed the faster onset of full local anesthesia (p < 0.05) by application of our modified NBA in comparison to IVRA about 10 minutes. Conclusion and discussion: Despite of available references showing faster onset of foot local anesthesia of IVRA, our study demonstrated that our modified four point NBA not only can be well known as a standard foot local anesthesia method applicable to desensitize the hind limb of dairy cows, but also, selection of this modified validated local anesthesia method can lead to have a faster start of complete desensitization of distal hind limb that is remarkable in any bovine limb interventions under time constraint.

Keywords: IVRA, four point NBA, dairy cow, hind limb, full onset

Procedia PDF Downloads 132
381 Assessing Walkability in New Cities around Cairo

Authors: Lobna Ahmed Galal

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Modal integration has given minimal consideration in cities of developing countries, as well as the declining dominance of public transport, and predominance of informal transport, the modal share of informal taxis in greater Cairo has increased from 6% in 1987 to 37% in 2001 and this has since risen even higher, informal and non-motorized modes of transport acting as a gap filler by feeding other modes of transport, not by design or choice, but often by lack of accessible and affordable public transport. Yet non-motorized transport is peripheral, with minimal priority in urban planning and investments, lacking of strong polices to support non-motorized transport, for authorities development is associated with technology and motorized transport, and promotion of non-motorized transport may be considered corresponding to development, as well as social stigma against non-motorized transport, as it is seen a travel mode for the poor. Cairo as a city of a developing country, has poor quality infrastructure for non-motorized transport, suffering from absence of dedicated corridors, and when existing they are often encroached for commercial purposes, widening traffic lanes at the expense of sidewalks, absence of footpaths, or being overcrowded, poor lighting, making walking unsafe and yet, lack of financial supply to such facilities as it is often considered beyond city capabilities. This paper will deal with the objective measuring of the built environment relating to walking, in some neighborhoods of new cities around Cairo, In addition to comparing the results of the objective measures of the built environment with the level of self-reported survey. The first paper's objective is to show how the index ‘walkability of community neighborhoods’ works in the contexts in neighborhoods of new cities around Cairo. The procedure of objective measuring is of a high potential to be carried out by using GIS.

Keywords: assessing, built environment, Cairo, walkability

Procedia PDF Downloads 356
380 Urban Renewal from the Perspective of Industrial Heritage Protection: Taking the Qiaokou District of Wuhan as an Example

Authors: Yue Sun, Yuan Wang

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Most of the earliest national industries in Wuhan are located along the Hanjiang River, and Qiaokou is considered to be a gathering place for Dahankou old industrial base. Zongguan Waterworks, Pacific Soap Factory, Fuxin Flour Factory, Nanyang Tobacco Factory and other hundred-year-old factories are located along Hanjiang River in Qiaokou District, especially the Gutian Industrial Zone, which was listed as one of 156 national restoration projects at the beginning of the founding of the People’s Republic of China. After decades of development, Qiaokou has become the gathering place of the chemical industry and secondary industry, causing damage to the city and serious pollution, becoming a marginalized area forgotten by the central city. In recent years, with the accelerated pace of urban renewal, Qiaokou has been constantly reforming and innovating, and has begun drastic changes in the transformation of old cities and the development of new districts. These factories have been listed as key reconstruction projects, and a large number of industrial heritage with historical value and full urban memory have been relocated, demolished and reformed, with only a few factory buildings preserved. Through the methods of industrial archaeology, image analysis, typology and field investigation, this paper analyzes and summarizes the spatial characteristics of industrial heritage in Qiaokou District, explores urban renewal from the perspective of industrial heritage protection, and provides design strategies for the regeneration of urban industrial sites and industrial heritage.

Keywords: industrial heritage, urban renewal, protection, urban memory

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379 Role of Teachers in Fostering the Culture of Peace in Higher Education Context: A Literature Review

Authors: Maliheh Rezaei

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Peace education has been introduced into many higher educational contexts by designing different programs, expecting to result in constructive changes, specifically in post-conflict countries. Teachers are the potential agents of positive change who play a major role in fostering the culture of peace in their classes. The purpose of this literature review was thus to evaluate the implementation of peace pedagogies by teachers in the context of higher education. More specifically, it addressed a) the role and characteristics of teachers and b) the pedagogies that they used to construct the culture of peace. The systematic literature review was used and several inclusion criteria were applied. Only papers published in English, which contained the keywords of university, higher education, peace, peace education, and similar derivatives such as ‘peacebuilding’ in their title and/or abstract, were included in this review. Moreover, only papers that dealt with the actual implementation of peace education theories were investigated. Findings highlighted that most teachers relied on pedagogies adopted from social justice, global citizenship, and positive psychology practices aiming to foster positive human traits such as resilience, empathy and reflection that were also believed to play an important role in peacebuilding efforts. Nevertheless, the incorporation of peace remained peripheral. The main challenge to incorporate the tenets of peace education was the shortage of teachers who were skilled and qualified enough to incorporate and promote the culture of peace in their classes. This literature review presents the body of research that has linked peace education to Higher Education. Therefore, it informs teachers about the potential roles they have in creating a peaceful and sustainable future. It also presents them with more effective pedagogies and practices to successfully integrate peace-related activities in Higher Education.

Keywords: culture of peace, higher education, teacher, pedogogy

Procedia PDF Downloads 175
378 Role of Transient Receptor Potential Vanilloid 1 in Electroacupuncture Analgesia on Chronic Inflammatory Pain in Mice

Authors: Jun Yang, Ching-Liang Hsieh, Yi-Wen Lin

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Chronic inflammatory pain results from peripheral tissue injury or local inflammation to increase the release of protons, histamines, adenosine triphosphate, and several proinflammatory cytokines. Transient receptor potential vanilloid 1 (TRPV1) is involved in fibromyalgia, neuropathic, and inflammatory pain; however, its exact mechanisms in chronic inflammatory pain are still unclear. We investigate the analgesic effect of EA by injecting complete Freund’s adjuvant (CFA) in the hind paw of mice to induce chronic inflammatory pain ( > 14 d). Our results showed that EA significantly reduced chronic mechanical and thermal hyperalgesia in the chronic inflammatory pain model. Chronic mechanical and thermal hyperalgesia was also abolished in TRPV1−/− mice. TRPV1 increased in the dorsal root ganglion (DRG) and spinal cord (SC) at 2 weeks after CFA injection. The expression levels of downstream molecules such as pPKA, pPI3K, and pPKC increased, as did those of pERK, pp38, and pJNK. Transcription factors (pCREB and pNFκB) and nociceptive ion channels (Nav1.7 and Nav1.8) were involved in this process. Inflammatory mediators such as GFAP (Glial fibrillary acidic protein), S100B, and RAGE (Receptor for advanced glycation endproducts) were also involved. The expression levels of these molecules were reduced in EA (electroacupuncture) and TRPV1−/−mice but not in the sham EA group. The present study demonstrated that EA or TRPV1 gene deletion reduced chronic inflammatory pain through TRPV1 and related molecules. In addition, our data provided evidence to support the clinical use of EA for treating chronic inflammatory pain.

Keywords: auricular electric-stimulation, epileptic seizures, anti-inflammation, electroacupuncture

Procedia PDF Downloads 153
377 Using Genetic Algorithm to Organize Sustainable Urban Landscape in Historical Part of City

Authors: Shahab Mirzaean Mahabadi, Elham Ebrahimi

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The urban development process in the historical urban context has predominately witnessed two main approaches: the first is the Preservation and conservation of the urban fabric and its value, and the second approach is urban renewal and redevelopment. The latter is generally supported by political and economic aspirations. These two approaches conflict evidently. The authors go through the history of urban planning in order to review the historical development of the mentioned approaches. In this article, various values which are inherent in the historical fabric of a city are illustrated by emphasizing on cultural identity and activity. In the following, it is tried to find an optimized plan which maximizes economic development and minimizes change in historical-cultural sites simultaneously. In the proposed model, regarding the decision maker’s intention, and the variety of functions, the selected zone is divided into a number of components. For each component, different alternatives can be assigned, namely, renovation, refurbishment, destruction, and change in function. The decision Variable in this model is to choose an alternative for each component. A set of decisions made upon all components results in a plan. A plan developed in this way can be evaluated based on the decision maker’s point of view. That is, interactions between selected alternatives can make a foundation for the assessment of urban context to design a historical-cultural landscape. A genetic algorithm (GA) approach is used to search for optimal future land use within the historical-culture landscape for a sustainable high-growth city.

Keywords: urban sustainability, green city, regeneration, genetic algorithm

Procedia PDF Downloads 49
376 Mechanical and Biodegradability of Porous Poly-ε-Caprolactone/Polyethylene Glycol Copolymer-Reinforced Cellulose Nanofibers for Soft Tissue Engineering Applications

Authors: Mustafa Abu Ghalia, Mohammed Seddik

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The design and development of a new class of biomaterial has gained particular interest in producing polymer scaffold for biomedical applications. Improving mechanical properties, biological and controlling pores scaffold are important factors to provide appropriate biomaterial for implement in soft tissue repair and regeneration. In this study, poly-ε-caprolactone (PCL) /polyethylene glycol (PEG) copolymer (80/20) incorporated with CNF scaffolds were made employing solvent casting and particulate leaching methods. Four mass percentages of CNF (1, 2.5, 5, and 10 wt.%) were integrated into the copolymer through a silane coupling agent. Mechanical properties were determined using Tensile Tester data acquisition to investigate the effect of porosity, pore size, and CNF contents. Tensile strength obtained for PCL/PEG- 5 wt.% CNF was 16 MPa, which drastically decreased after creating a porous structure to 7.1 MPa. The optimum parameters of the results were found to be 5 wt.% for CNF, 240 μm for pore size, and 83% for porosity. Scanning electron microscopy (SEM) micrograph reveals that consistent pore size and regular pore shape were accomplished after the addition of CNF-5 wt. % into PCL/PEG. The results of mass loss of PCL/PEG reinforced-CNF 1% have clearly enhanced to double values compared with PCL/PEG copolymer and three times with PCL/PEG scaffold-CNF 1%. In addition, all PCL/PEG reinforced and scaffold- CNF were partially disintegrated under composting conditions confirming their biodegradable behavior. This also provides a possible solution for the end life of these biomaterials.

Keywords: PCL/PEG, cellulose nanofibers, tissue engineering, biodegradation, compost polymers

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375 The Effect of the Epstein-Barr Virus on the Development of Multiple Sclerosis

Authors: Sina Mahdavi

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Background and Objective: Multiple sclerosis (MS) is the most common inflammatory autoimmune disease of the central nervous system (CNS) that affects the myelination process in the CNS. Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially Epstein-Barr virus (EBV) and MS, is one potential cause that is not well understood. In this study, we aim to summarize the available data on EBV infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis," "Epstein-Barr virus," and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2016 and 2022 were searched, and 14 articles were chosen, studied, and analyzed. Results: Demyelinated lesions isolated from MS patients contain EBNAs from EBV proteins. The EBNA1 domain contains a pentapeptide fragment identical to B-crystallin, a heat shock peptide, that is increased in peripheral B cells in response to B-crystallin infection, resulting in myelin-directed autoimmunity mediated by proinflammatory T cells. EBNA2, which is involved in the regulation of viral transcription, may enhance transcription from MS risk loci. A 7-fold increase in the risk of MS has been observed in EBV infection with HLA-DR15 synergy. Conclusion: EBV infection along with a variety of specific genetic risk alleles, cause inflammatory cascades in the CNS by infected B cells. There is a high expression of EBV during the course of MS, which indicates the relationship between EBV and MS, that this virus can play a role in the development of MS by creating an inflammatory state. Therefore, measures to modulate the expression of EBV may be effective in reducing inflammatory processes in demyelinated areas of MS patients.

Keywords: multiple sclerosis, Epstein-Barr virus, central nervous system, EBNAs

Procedia PDF Downloads 73
374 The First Report of Aberrant Corneal Occlusion in Rabbit in Iran

Authors: Bahador Bardshiri, Omid Moradi, Amir Komeilian, Nima Panahifar

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Formation of a conjunctival membrane over the corneal surface is a condition unique to rabbits that has been labeled aberrant corneal occlusion or pseudopterygium. In the summer of 2013, a five years old male Standard Chinchilla rabbit were presented to Karaj Central Veterinary hospital and the owner complained that his rabbit shows degrees of blindness and there were opacities on both eyes of the presented rabbit. Ophthalmic examination of the affected eyes revealed a conjunctival fold stretching over the cornea of both eyes. The fold originated from limbus and it was vascularized and centrally thickened. There were no attachments to the corneal epithelium and the fold could be easily lifted. Surgery was performed under general anesthesia. The conjunctival fold was incised centrifugally up to its attachment at the limbus and the lid margin using small scissors. The central rim of the segment was then replaced to its normal position in the fornix and fixed with mattress sutures (7/0) passing through outside skin. After the surgery, eye drops containing dexamethasone, gentamicin and polymixin were applied twice daily up to 3 weeks. Within the observation period (8 months) no recurrence was noted. "Pseudo" in the term pseudopterygium refers to the fact that the conjunctival membrane is not adhering to the underlying cornea, but growing over it. In rare cases, the membrane may be loosely attached to the cornea, but can be easily separated without causing damage. It can cover only a small part of the cornea with an annular peripheral opacification of the cornea, or cover it almost fully, leading to blindness. Ethiopathogenesis remains unclear and recurrence of the problem is very likely. The surgical technique that used here decreases probability of recurrence of conjunctival fold.

Keywords: rabbit, cornea, aberrant corneal occlusion, pseudopterygium

Procedia PDF Downloads 316
373 The Effect of Magnesium Supplement on the Athletic Performance of Field Athletes

Authors: M. Varmaziar

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Magnesium (Mg) is an essential mineral that plays a crucial role in the human body. Certain types of foods, including nuts, grains, fruits, vegetables, and whole grains, are rich sources of magnesium. Mg serves as an essential cofactor for numerous enzymatic reactions, including energy metabolism, cellular growth, glycolysis, and protein synthesis. The Mg-ATP complex serves as an energy source and is vital for many physiological functions, including nerve conduction, muscle contraction, and blood pressure regulation. Despite the vital role of magnesium in energy metabolism, maintaining adequate magnesium intake is often overlooked among the general population and athletes. The aim of this study was to investigate the effect of magnesium supplementation on the physical activities of field athletes. Field athletes were divided into two groups: those who consumed magnesium supplements and those who received a placebo. These two groups received either 500 mg of magnesium oxide or a placebo daily for 8 weeks. At the beginning and end of the study, athletes completed ISI questionnaires and physical activity assessments. Nutritional analyses were performed using N4 software, and statistical analyses were conducted using SPSS19 software. The results of this study revealed a significant difference between the two study groups. Athletes who received magnesium supplements experienced less fatigue related to field athletic activities and muscle soreness. In contrast, athletes who received the placebo reported more significant fatigue and muscle soreness. A concerning finding in these results is that the performance of athletic activities may be at risk with low magnesium levels. Therefore, magnesium is essential for maintaining health and plays a crucial role in athletic performance. Consuming a variety of magnesium-rich foods ensures that individuals receive an adequate amount of this essential nutrient in their diet. The consumption of these foods improves performance parameters in athletic exercises.

Keywords: athletic performance, effect, field athletes, magnesium supplement

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372 Modelling the Impacts of Geophysical Parameters on Deforestation and Forest Degradation in Pre and Post Ban Logging Periods in Hindu Kush Himalayas

Authors: Alam Zeb, Glen W. Armstrong, Muhammad Qasim

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Loss of forest cover is one of the most important land cover changes and has been of great concern to policy makers. This study quantified forest cover changes over pre logging ban (1973-1993) and post logging ban (1993-2015) to examine the role of geophysical factors and spatial attributes of land in the two periods. We show that despite a complete ban on green felling, forest cover decreased by 28% and mostly converted to rangeland. Nevertheless, the logging ban was completely effective in controlling agriculture expansion. The binary logistic regression revealed that the south facing aspects at low elevation witnessed more deforestation in the pre-ban period compared to post-ban. Opposite to deforestation, forest degradation was more prominent on the northern aspects at higher elevation during the policy period. Agriculture expansion was widespread in the low elevation flat areas with gentle slope, while during the policy period agriculture contraction in the form of regeneration was observed on the low elevation areas of north facing slopes. All proximity variables, except distance to administrative boundary, showed a similar trend across the two periods and were important explanatory variables in understanding forest and agriculture expansion. The changes in determinants of forest and agriculture expansion and contraction over the two periods might be attributed to the influence of policy and a general decrease in resource availability.

Keywords: forest conservation , wood harvesting ban, logistic regression, deforestation, forest degradation, agriculture expansion, Chitral, Pakistan

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371 SockGEL/PLUG: Injectable Nano-Scaled Hydrogel Platforms for Oral and Maxillofacial Interventional Application

Authors: Z. S. Haidar

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Millions of teeth are removed annually, and dental extraction is one of the most commonly performed surgical procedures globally. Whether due to caries, periodontal disease, or trauma, exodontia and the ensuing wound healing and bone remodeling processes of the resultant socket (hole in the jaw bone) usually result in serious deformities of the residual alveolar osseous ridge and surrounding soft tissues (reduced height/width). Such voluminous changes render the placement of a proper conventional bridge, denture, or even an implant-supported prosthesis extremely challenging. Further, most extractions continue to be performed with no regard for preventing the onset of alveolar osteitis (also known as dry socket, a painful and difficult-to-treat/-manage condition post-exodontia). Hence, such serious resorptive morphological changes often result in significant facial deformities and a negative impact on the overall Quality of Life (QoL) of patients (and oral health-related QoL); alarming, particularly for the geriatric with compromised healing and in light of the thriving longevity statistics. Despite advances in tissue/wound grafting, serious limitations continue to exist, including efficacy and clinical outcome predictability, cost, treatment time, expertise, and risk of immune reactions. For cases of dry socket, specifically, the commercially available and often-prescribed home remedies are highly-lacking. Indeed, most are not recommended for use anymore. Alveogyl is a fine example. Hence, there is a great market demand and need for alternative solutions. Herein, SockGEL/PLUG (patent pending), an innovative, all-natural, drug-free, and injectable thermo-responsive hydrogel, was designed, formulated, characterized, and evaluated as an osteogenic, angiogenic, anti-microbial, and pain-soothing suture-free intra-alveolar dressing, safe and efficacious for use in fresh extraction sockets, immediately post-exodontia. It is composed of FDA-approved, biocompatible and biodegradable polymers, self-assembled electro-statically to formulate a scaffolding matrix to (1) prevent the on-set of alveolar osteitis via securing the fibrin-clot in situ and protecting/sealing the socket from contamination/infection; and (2) endogenously promote/accelerate wound healing and bone remodeling to preserve the volume of the alveolus. The intrinsic properties of the SockGEL/PLUG hydrogel were evaluated physical-chemical-mechanically for safety (cell viability), viscosity, rheology, bio-distribution, and essentially, capacity to induce wound healing and osteogenesis (small defect, in vivo) without any signaling cues from exogenous cells, growth factors or drugs. The proposed animal model of cranial critical-sized and non-vascularized bone defects shall provide new and critical insights into the role and mechanism of the employed natural bio-polymer blend and gel product in endogenous reparative regeneration of soft tissues and bone morphogenesis. Alongside, the fine-tuning of our modified formulation method will further tackle appropriateness, reproducibility, scalability, ease, and speed in producing stable, biodegradable, and sterilizable thermo-sensitive matrices (3-dimensional interpenetrating yet porous polymeric network) suitable for the intra-socket application. Findings are anticipated to provide sufficient evidence to translate into pilot clinical trials and validate the innovation before engaging the market for feasibility, acceptance, and cost-effectiveness studies.

Keywords: hydrogel, nanotechnology, bioengineering, bone regeneration, nanogel, drug delivery

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370 A Method for Precise Vertical Position of the Implant When Using Computerized Surgical Guides and Bone Reduction

Authors: Abraham Finkelman

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Computerized Surgical Guides have been proven to be a predictable way to perform dental implants, with a relatively high accuracy in comparison to a treatment plan. When using the CSG Bone supported, it allows us to make the necessary changes of the hard tissue prior to the implant placement and after the implant placement. The CSG gives us an accurate position for the drilling, and during the implant placement it allows us to alter the vertical position of the implant altering the final position of the abutment and avoiding any risk of any damage to the adjacent anatomical structures. Any Changes required to the bone level can be done prior to the fixation of the CSG using a reduction guide, which incur extra surgical fees and the need of a second surgical guide. Any changes of the bone level after the implant placement are at the risk of damaging the implant neck surface. The technique consists of a universal system that allows us to remove the excess bone around the implant sockets prior to the implant placement which then enables us to place the implant in the vertical position with accuracy as planned with the CSG. The systems consist of a hollow pin of different sizes and diameters. Depending on the implant system that we are using. Length sizes are from 6mm-16mm and a diameter of 2.6mm-4.8mm. Upon the completion of the drilling, the pin is then inserted into the implant socket-using the insertion tool. Once the insertion tool has unscrewed the pin, we can continue with the bone reduction. The bone reduction can be done using conventional methods upon the removal of all the excess bone around the pin. The insertion tool is then screwed into the pin and the pin is then removed. We now, have the new bone level at the crest of the implant socket which is our mark for the vertical position of the implant. In some cases, when we are locating the implant very close to anatomical structures, any form of deviation to the vertical position of the implant during the surgery, can cause damage to such anatomical structures, creating irreversible damages such as paresthesia or dysesthesia of the mandibular nerve. If we are planning for immediate loading and we have done our temporary restauration in base of our computerized plan, deviation in the vertical position of the implant will affect the position of the abutment, affecting the accuracy of the temporary prosthesis, extending the working time till we adapt the prosthesis to the new position.

Keywords: bone reduction, computer aided navigation, dental implant placement, surgical guides

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369 Glenoid Osteotomy with Various Tendon Transfers for Brachial Plexus Birth Palsy: Clinical Outcomes

Authors: Ramin Zargarbashi, Hamid Rabie, Behnam Panjavi, Hooman Kamran, Seyedarad Mosalamiaghili, Zohre Erfani, Seyed Peyman Mirghaderi, Maryam Salimi

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Background: Posterior shoulder dislocation is one of the disabling complications of brachial plexus birth injury (BPBI), and various treatment options, including capsule and surrounding muscles release for open reduction, humeral derotational osteotomy, and tendon transfers, have been recommended to manage it. In the present study, we aimed to determine the clinical outcome of open reduction with soft tissue release, tendon transfer, and glenoid osteotomy inpatients with BPBI and posterior shoulder dislocation or subluxation. Methods: From 2018 to 2020, 33 patients that underwent open reduction, glenoid osteotomy, and tendon transfer were included. The glenohumeral deformity was classified according to the Waters radiographic classification. Functional assessment was performed using the Mallet grading system before and at least two years after the surgery. Results: The patients were monitored for 26.88± 5.47 months. Their average age was 27.5±14 months. Significant improvement was seen in the overall Mallet score (from 13.5 to 18.91 points) and its segments, including hand to mouth, hand to the neck, global abduction, global external rotation, abduction degree, and external rotation degree. Hand-to-back score and the presence of trumpet sign were significantly decreased in the post-operation phase (all p values<0.001). The above-mentioned variables significantly changed for both infantile and non-infantile dislocations. Conclusion: Our study demonstrated that open reduction along with glenoid osteotomy improves retroversion, and muscle strengthening with different muscle transfers is an effective technique for BPBI.

Keywords: birth injuries, nerve injury, brachial plexus birth palsy, Erb palsy, tendon transfer

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368 Russia’s Role in Resolving the Nagorno-Karabakh Conflict 1990-2020

Authors: Friba Haidari

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The aim of the study is to identify Russia's role in managing the Nagorno-Karabakh conflict betweenArmenia and Azerbaijan during the years 1990 to 2020. The Nagorno-Karabakh crisis can not be considered a mere territorial conflict but also a crossroads of interests of foreign actors. Geopolitical rivalries and the access to energy by regional and trans-regional actors have complicated the crisis and created a security challenge in the region, which is likely to escalate into a full-blown war between the parties involved. The geopolitical situation of Nagorno-Karabakh and its current situation have affected all peripheral states in some way. Russia, as one of the main actors in this scene, has been actively involved since the beginning of the crisis. The Russians have always sought to strengthen their influence and presence in the Nagorno-Karabakh crisis. Russia's efforts to weaken the role of the Minsk Group, The presence of Western actors, and the deployment of Russian forces in the disputed area can be assessed in this context. However, this study seeks to answer the question of what role did Russia play in managing the Nagorno-Karabakh conflict between Armenia and Azerbaijan between 1990 and 2020? The study hypothesizes that Russia has prevented the escalation of the Nagorno-Karabakh conflict through mediation and some coercion. This study is divided into four parts, including conflict management as a theoretical framework; Examining the competition and the role of actors in the Caucasus region, especially the role of the Minsk Group, and what approach or tools and methods Russia has used in its foreign policy in managing the conflict, and finally what are the relations between the countries involved and what will be Russia's role in the future? Was discussed. This study examines the analysis and transfer of ideas and information using authoritative international sources with an explanatory method and shares its results with everyone.

Keywords: Russia, conflict, nagorno-karabakh, management

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367 The Healing Effect of Unrestricted Somatic Stem Cells Loaded in Collagen-Modified Nanofibrous PHBV Scaffold on Full-Thickness Skin Defects

Authors: Hadi Rad

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Unrestricted somatic stem cells (USSCs) loaded in nanofibrous PHBV scaffold can be used for skin regeneration when grafted into full-thickness skin defects of rats. Nanofibrous PHBV scaffolds were designed using electrospinning method and then, modified with the immobilized collagen via the plasma method. Afterward, the scaffolds were evaluated using scanning electron microscopy, physical and mechanical assays. In this study; nanofibrous PHBV scaffolds loaded with and without USSCs were grafted into the skin defects. The wounds were subsequently investigated at 21 days after grafting. Results of mechanical and physical analyses showed good resilience and compliance to movement as a skin graft. In animal models; all study groups excluding the control group exhibited the most pronounced effect on wound closure, with the statistically significant improvement in wound healing being seen on post-operative Day 21. Histological and immunostaining examinations of healed wounds from all groups, especially the groups treated with stem cells, showed a thin epidermis plus recovered skin appendages in the dermal layer. Thus, the graft of collagen-coated nanofibrous PHBV scaffold loaded with USSC showed better results during the healing process of skin defects in rat model.

Keywords: collagen, nanofibrous PHBV scaffold, unrestricted somatic stem cells, wound healing.

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366 Conservation Status of a Lowland Tropical Forest in South-West, Nigeria

Authors: Lucky Dartsa Wakawa, Friday Nwabueze Ogana, Temitope Elizabeth Adeniyi

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Timely and reliable information on the status of a forest is essential for assessing the extent of regeneration and degradation. However, when such information is lacking effective forest management practices becomes impossible. Therefore, this study assessed the tree species composition, richness, diversity, structure of Oluwa forest reserve with the view of ascertaining it conservation status. A systematic line transect was used in the laying of eight (8) temporary sample plots (TSPs) of size 50m x 50m. Trees with Dbh ≥ 10cm in the selected plots were enumerated, identified and measured. The results indicate that 535 individual trees were enumerated cutting across 26 families and 58 species. The family Sterculiaceae recorded the highest number of species (10) and occurrence (112) representing 17.2% and 20.93% respectively. Celtis zenkeri is the species with the highest number of occurrence of tree per hectare and importance value index (IVI) of 59 and 53.81 respectively. The reserve has the Margalef's index of species richness, Shannon-Weiner diversity Index (H') and Pielou's Species Evenness Index (EH) of 9.07, 3.43 and 0.84 respectively. The forest has a mean Dbh (cm), mean height (m), total basal area/ha (m2) and total volume/ha (m3) of 24.7, 16.9, 36.63 and 602.09 respectively. The important tropical tree species identified includes Diospyros crassiflora Milicia excels, Mansonia altisima, Triplochiton scleroxylon. Despite the level of exploitation in the forest, the forest seems to be resilience. Given the right attention, it could regenerate and replenish to save some of the original species composition of the reserve.

Keywords: forest conservation, forest structure, Lowland tropical forest, South-west Nigeria

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365 Arsenic Removal from Drinking Water by Hybrid Hydrogel-Biochar Matrix: An Understanding of Process Parameters

Authors: Vibha Sinha, Sumedha Chakma

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Arsenic (As) contamination in drinking water is a serious concern worldwide resulting in severe health maladies. To tackle this problem, several hydrogel based matrix which selectively uptake toxic metals from contaminated water has increasingly been examined as a potential practical method for metal removal. The major concern in hydrogels is low stability of matrix, resulting in poor performance. In this study, the potential of hybrid hydrogel-biochar matrix synthesized from natural plant polymers, specific for As removal was explored. Various compositional and functional group changes of the elements contained in the matrix due to the adsorption of As were identified. Moreover, to resolve the stability issue in hydrogel matrix, optimum and effective mixing of hydrogel with biochar was studied. Mixing varied proportions of matrix components at the time of digestion process was tested. Preliminary results suggest that partial premixing methods may increase the stability and reduce cost. Addition of nanoparticles and specific catalysts with different concentrations of As(III) and As(V) under batch conditions was performed to study their role in performance enhancement of the hydrogel matrix. Further, effect of process parameters, optimal uptake conditions and detailed mechanism derived from experimental studies were suitably conducted. This study provides an efficient, specific and a low-cost As removal method that offers excellent regeneration abilities which can be reused for value.

Keywords: arsenic, catalysts, hybrid hydrogel-biochar, water purification

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364 Implementing 3D Printing for 3D Digital Modeling in the Classroom

Authors: Saritdikhun Somasa

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3D printing fabrication has empowered many artists in many fields. Artists who work in stop motion, 3D modeling, toy design, product design, sculpture, and fine arts become one-stop shop operations–where they can design, prototype, and distribute their designs for commercial or fine art purposes. The author has developed a digital sculpting course that fosters digital software, peripheral hardware, and 3D printing with traditional sculpting concept techniques to address the complexities of this multifaceted process, allowing the students to produce complex 3d-printed work. The author will detail the preparation and planning for pre- to post-process 3D printing elements, including software, materials, space, equipment, tools, and schedule consideration for small to medium figurine design statues in a semester-long class. In addition, the author provides insight into teaching challenges in the non-studio space that requires students to work intensively on post-printed models to assemble parts, finish, and refine the 3D printed surface. Even though this paper focuses on the 3D printing processes and techniques for small to medium design statue projects for the Digital Media program, the author hopes the paper will benefit other fields of study such as craft practices, product design, and fine-arts programs. Other schools that might implement 3D printing and fabrication in their programs will find helpful information in this paper, such as a teaching plan, choices of equipment and materials, adaptation for non-studio spaces, and putting together a complete and well-resolved project for students.

Keywords: 3D digital modeling, 3D digital sculpting, 3D modeling, 3D printing, 3D digital fabrication

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363 Glaucoma with Normal IOP, Is It True Normal Tension glaucoma or Something Else!

Authors: Sushma Tejwani, Shoruba Dinakaran, Kushal Kacha, K. Bhujang Shetty

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Introduction and aim: It is not unusual to find patients with glaucomatous damage and normal intraocular pressure, and to label a patient as Normal tension glaucoma (NTG) majority of clinicians depend on office Intraocular pressures (IOP) recordings; hence, the concern is that whether we are missing the late night or early morning spikes in this group of patients. Also, ischemia to the optic nerve is one of the presumed causes of damage in these patients, however demonstrating the same has been a challenge. The aim of this study was to evaluate IOP variations and patterns in a series of patients with open angles, glaucomatous discs or fields but normal office IOP, and in addition to identify ischemic factors for true NTG patients. Materials & Methods: This was an observational cross- sectional study from a tertiary care centre. The patients that underwent full day DVT from Jan 2012 to April 2014 were studied. All patients underwent IOP measurement on Goldmann applanation tonometry every 3 hours for 24 hours along with a recording of the blood pressure (BP). Further patients with normal IOP throughout the 24- hour period were evaluated with a cardiologist for echocardiography and carotid Doppler. Results: There were 47 patients and a maximum number of patients studied was in the age group of 50-70 years. A biphasic IOP peak was noted for almost all the patients. Out of the 47 patients, 2 were excluded from analysis as they were on treatment.20 patients (42%) were diagnosed on DVT to have an IOP spike and were then diagnosed as open angle glaucoma and another 25 (55%) were diagnosed to have normal tension glaucoma and were subsequently advised a carotid Doppler and a cardiologists consult. Another interesting finding was that 9 patients had a nocturnal dip in their BP and 3 were found to have carotid artery stenosis. Conclusion: A continuous 24-hour monitoring of the IOP and BP is a very useful albeit mildly cumbersome tool which provides a wealth of information in cases of glaucoma presenting with normal office pressures. It is of great value in differentiating between normal tension glaucoma patients & open angle glaucoma patients. It also helps in timely diagnosis & possible intervention due to referral to a cardiologist in cases of carotid artery stenosis.

Keywords: carotid artery disease in NTG, diurnal variation of IOP, ischemia in glaucoma, normal tension glaucoma

Procedia PDF Downloads 267