Search results for: primary health care

Authors: Houda Mnif Sellami, Toshi Umehara, Yuriko Yamazaki, Reie Matoba, Anna Sakashita, Yoshimi Abe, Hiroyuki Otake, Satoko Morita, Yoshitaka Akiyama, Chieko Morisawa, Eiji Omura, Masako Yazawa, Yoshie Koike, Mitsugu Tokunaga, Seiki Wada, Shinya Minagawa, Masafumi Matsuda

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Childhood obesity has been, for decades, a very serious public health problem worldwide. Some Asian countries have already reached alarming rates, as lifestyle changed dramatically in this part of the world. In many concerned countries, strategies including educational, promotional and awareness-raising activities have been established to combat obesity within kids. Objective: To estimate the obesity and also the underweight trends of Japanese kids from 5 to 17 years, by single year of age and by gender, over the last decade. Methods We used the data from the cross-sectional annual Nationwide surveys (National Nutrition Survey, Japan, Ministry of education, culture, sports, science and technology) conducted from 2007 to 2016. We compared trajectories of obesity prevalence, with the data on sex and age groups. We also analyzed energy and macronutrients intakes of Japanese kids using Ministry of Health, Labor and Welfare-Japan annual data, from 2007 to 2014. Results: From 2007 to 2016, Boys obesity was higher than Girls obesity for the over 6 YO participants. Both Boys and Girls obesity trends had 2 peaks of prevalence at (11-13 YO) and then at (15-16 YO). From 2007 to 2012, Kids obesity decreased considerably in both sex and all year of age; then obesity decline was more modest till 2016.On the other side, Kids underweight prevalence increased in both sexes. The macronutrients analyze couldn’t show an evident association between obesity trends and foods intake. Conclusion: Japanese kids’ obesity has been decreased since 2007, in opposition to some other countries reports. We didn’t find an observed association with food intake using Health Ministry data; we need further investigation to estimate energy intake, lifestyle and physical activity by year of age to know whether there is any possible relation.

Keywords: childhood, Japan, obesity, underweight

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Authors: Iram Zahair, Tanith Rose, Oyinlola Oyebode, Stephen Clayton, Iman Ghosh, Michelle Maden, Ben Barr

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Background: Gastrointestinal infections exert a significant public health burden on UK healthcare services and the community. However, there are conflicting findings on where ethnic inequalities are likely to persist. This systematic review aimed to identify studies that ascertain differences in the incidence and prevalence of gastrointestinal infections within and between UK ethnic groups and explore possible explanations for heterogeneity observed within the literature. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, a systematic review methodology was used. Medline, Web of Science, CINAHL Plus, and grey literature were searched from 1980 to 2021 for studies reporting an association between ethnicity and gastrointestinal infections in UK population samples. Two reviewers independently screened the articles and conducted quality appraisals; data extraction was undertaken by one reviewer and verified by two reviewers (PROSPERO CRD 42021240714). A narrative synthesis was undertaken to synthesise the study findings. Results: The searches identified 8134 studies; 13 met the inclusion criteria. 12 out of 13 studies found a difference in the prevalence of gastrointestinal infections between different ethnic groups. UK ethnic minorities, predominantly men and children of Asian ethnicity, had an increased risk of infection than the white British majority in 12 studies; the Pakistani ethnic group had a higher risk of infection in three out of 13 studies. Studies reported that age and sex confounded the relationship between ethnicity and gastrointestinal infections. At the same time, the country of birth, socioeconomic status, and geographical location of ethnic groups mediated this association and significantly explained the heterogeneity observed across the studies. Harvest plots supported the textual synthesis. Conclusion: This systematic review elucidates the lack of extensive UK quantitative evidence examining the association between ethnicity and gastrointestinal infections. Insights into gastrointestinal infections and ethnicity's association can help address policy actions to mitigate the inequalities identified within and between UK ethnic groups.

Keywords: ethnic and racial populations, public health, public health policy, systematic review

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Authors: Patrick Mueller, Alan Martin, Justin Stockwell, Robert Goldblatt

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Elevated concentrations of inorganic nitrogen (N) compounds (nitrate, nitrite, and ammonia) are a ubiquitous feature to mine-influenced drainages due to the leaching of blasting residues and use of cyanide in the milling of gold ores. For many mines, the management of N is a focus for environmental protection, therefore understanding the factors controlling the speciation and behavior of N is central to effective decision making. In this paper, the passive attenuation of ammonia and nitrite is described for three northern water bodies (two lakes and a tailings pond) influenced by mining activities. In two of the water bodies, inorganic N compounds originate from explosives residues in mine water and waste rock. The third water body is a decommissioned tailings impoundment, with N compounds largely originating from the breakdown of cyanide compounds used in the processing of gold ores. Empirical observations from water quality monitoring indicate nitrification (the oxidation of ammonia to nitrate) occurs in all three waterbodies, where enrichment of nitrate occurs commensurately with ammonia depletion. The N species conversions in these systems occurred more rapidly than chemical oxidation kinetics permit, indicating that microbial mediated conversion was occurring, despite the cool water temperatures. While nitrification of ammonia and nitrite to nitrate was the primary process, in all three waterbodies nitrite was consistently present at approximately 0.5 to 2.0 % of total N, even following ammonia depletion. The persistence of trace amounts of nitrite under these conditions suggests the co-occurrence denitrification processes in the water column and/or underlying substrates. The implications for N management in mine waters are discussed.

Keywords: explosives, mining, nitrification, water

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Authors: M. Hetmańczyk, R. Polaniak, K. Brukało, E. Grochowska-Niedworok

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Eating behaviours of people are determined by knowledge gained at different stages of life. Children’s diet is especially important. They have to eat meals regularly. Meals should consist of protein, carbohydrates and fat, and drinking the right amount of water. Mistakes in children’s diets affect their health and may lead to health issues such as diabetes, overweight, obesity or malnutrition. The aim of the study was to assess the eating habits among 10-15-year-old children. To achieve this aim, the study included children aged 10-15 years living in Silesia Province, Poland; the participants consisted of 52.08% girls and 47.92% boys. Authorial questionnaire contains 28 questions about eating habits. The results of 192 students were subjected to analysis. The results show that half of the surveyed students participated in physical activity every day. Most children ate 4-5 meals every day, but the breaks between them were too long (four and more hours). Children generally ate cooked meals. Most children ate first breakfast every day, but only one third of studied children ate a second breakfast daily, while 93.75% ate vegetables at least once a day, 94.79% ate fruit at least once a day, and 79.17% drink a daily glass of milk or more. The study found that the eating behaviours of the surveyed children were unsatisfying. While the children did not participate in physical activity often enough, girls took part slightly more often. Children eat second breakfast not often enough. Younger children (10-12 years old) are doing it more often than the older children (13-15 years old). Gender is not a determinant of the frequency of second breakfast consumption.

Keywords: eating habits, children, diet, nutrition status

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Authors: Anusha Sajjad, Sibtain Kazmi, Sadaf Sajjad, Ali Mohsin

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Shia Muslims, a distinct minority within the broader Muslim community, have a unique mourning practice set that remains underexplored in research. These practices hold cultural and religious significance and are essential to Shia spirituality. This study seeks to delve into the emotional and psychological dimensions of Shia Muslims' mourning rituals, specifically investigating how these practices serve as coping strategies during times of grief and adversity. The motivation for this research stems from a gap in understanding the psycho-spiritual aspects of Shia mourning, with a focus on the potential therapeutic value of these practices for individuals experiencing daily life stressors. This qualitative investigation employs an online survey conducted in September 2023 as the primary research method. Data was collected from a sample of 49 Shia Muslims who have actively participated in mourning rituals. Pearson's correlation test was applied to assess the relationship between participants’ reported feelings of mentally feeling ‘Lighter or Heavier' and their 'Coping' responses. Pearson's correlation analysis revealed a positive but relatively weak correlation between 'Mentally Feeling Lighter' and 'Coping' (r = 0.303) with a statistically significant p-value of 0.034. The findings suggest that there is a statistically significant positive correlation between feeling "Mentally Lighter" and coping, as reported by participants in Shia mourning rituals, although the strength of this correlation is relatively weak. This implies that individuals who feel "Mentally Lighter" are more likely to report coping effectively, but other factors likely contribute to the overall coping strategies employed by participants in this context. Further research with a larger sample size would be needed to strengthen this correlation further.

Keywords: shia, mourning, religion, coping

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Authors: Kalpeshkumar L. Gupta, Shivali Rathore

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India is home to over 30 crore rural poor, aware of the criticality of the situation that has made to come with an innovative business idea. Entrepreneurship in India is on the verge of explosive growth and which is actually need of an hour for employment generation, poverty elevation at grass root through developmental intervention. India economic progress has started from the development of its small and medium scale enterprises to ensure that the sectors continues to stay competitive and achieve sustained growth in the era of global economy many incubators centers has been established with the mission to give the encouragement to many innovative ideas. If we define an Incubator, it is simply an enclosed apparatus in which premature small babies are placed and which provides a controlled and protective environment for their care this gives them a chance to adjust to outside environment, and grow stronger before they face the outside world. In a similar way the startup entrepreneur’s business idea is incubated in the incubation centers. Entrepreneurship has been conventionally rated as risky career, to break the myth and to augment the supply of new entrepreneurs through education; research training the incubation centers has been established, their goal is to help create and grow young businesses by providing them with necessary support and financial and technical services. The startup companies spend on an average two years in a business incubator during which numerous benefits like funding, office space, equipment’s etc. is provided by the incubators to the startup business. Present paper will study the background, role, objectives of different incubators set up in Indian Institute of Management (IIMs) and Indian Institute of Technology (IITs) for our study.

Keywords: incubation centres, entrepreneurship, Indian Institute of Management, Indian Institute of Technology

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Authors: Lina Vyas

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Gender gap, unfortunately, is still prevalent in the workplace around the world. In most countries, women are less likely than men to participate in the workplace. They earn considerably less than men for doing the same work and are generally expected to prioritize family obligations over work responsibilities. Women often face more conflicts while balancing the increasingly normalized roles of both worker and mother. True gender equality in the workplace is still a long way off. In Hong Kong, no less is this true. Despite the fact that female students are outnumbered by males at universities, only 55% of women are active participants in the labour market, and for those in the workforce, the gender pay gap is 22%. This structural inequality also exacerbates the issues of confronting biases at work for choosing to be employed as a mother, as well as reinforces the societal expectation of women to be the primary caregiver at home. These pressures are likely to add up for women and contribute to increased levels of work-life conflict, which may be a further barrier for the inclusion of women into the workplace. Family-friendly policies have long been thought to be an alleviator of work-life conflict through helping employees balance the demands in both work and family. Particularly, for women, this could be a facilitator of their integration into the workplace. However, little research has looked at how family-friendly policies may also have a gender differential in effect, as opposed to traditional notions of having universal efficacy. This study investigates both how and how much the gender dimension impacts work-family conflict. In addition to disentangling the reasons for gender gaps existing in work-life conflict for women, this study highlights what can be done at an organizational level to alleviate these conflicts. Most importantly, the policies recommendations derived from this study serve as an avenue for more active participation for women in the workplace and can be considered as a pathway for promoting greater gender egalitarianism and fairness in a traditionally gender-segregated society.

Keywords: family-friendly policies, Hong Kong, work-family conflict, workplace

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Authors: Benyam Zenebe, Tesfaye Sisay, Gurja Belay, Workabeba Abebe

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Background: The prevalence and antibiogram of pathogenic E. coli strains, which cause diarrhea vary from region to region, and even within countries in the same geographical area. In Ethiopia, diagnostic approaches to E. coli induced diarrhea in children less than five years of age are not standardized. The aim of this study was to determine the involvement of pathogenic E. coli strains in child diarrhea and determine the antibiograms of the isolates in children less than 5 years of age with diarrhea at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A purposive study that included 98 diarrheic children less than five years of age was conducted at Addis Ababa University College of Health Sciences, TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia to detect pathogenic E. coli biotypes. Stool culture was used to identify presumptive E. coliisolates. Presumptive isolates were confirmed by biochemical tests, and antimicrobial susceptibility tests were performed on confirmed E. coli isolates by the disk diffusion method. DNA was extracted from confirmed isolates by a heating method and subjected to Polymerase Chain Reaction or the presence of virulence genes. Amplified PCR products were analyzed by agarose gel electrophoresis. Data were collected on child demographics and clinical conditions using administered questionnaires. The prevalence of E. coli strains from the total diarrheic children, and the prevalence of pathogenic strains from total E. coli isolates along with their susceptibility profiles; the distribution of pathogenic E.coli biotypes among different age groups and between the sexes were determined by using descriptive statistics. Result: Out of 98 stool specimens collected from diarrheic children less than 5 years of age, 75 presumptive E. coli isolates were identified by culture; further confirmation by biochemical tests showed that only 56 of the isolates were E. coli; 29 of the isolates were found in male children and 27 of them in female children. Out of the 58 isolates of E. coli, 25 pathotypes belonging to different classes of pathogenic strains: STEC, EPEC, EHEC, EAEC were detected by using the PCR technique. Pathogenic E. coli exhibited high rates of antibiotic resistance to many of the antibiotics tested. Moreover, they exhibited multiple drug resistance. Conclusion: This study found that the isolation rate of E. coli and the involvement of antibiotic-resistant pathogenic E. coli in diarrheic children is prominent, and hence focus should be given on the diagnosis and antimicrobial sensitivity testing of pathogenic E. coli at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital. Among antibiotics tested, Cefotitan could be a drug of choice to treat E. coli.

Keywords: antibiotic susceptibility profile, children, diarrhea, E. coli, pathogenic

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Authors: Asif Ali, Daud Salim Faruquie

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With the advancement of knowledge about the utility and impact of sustainability, its feasibility has been explored into different walks of life. Scientists, however; have established their knowledge in four areas viz environmental, economic, social and cultural, popularly termed as four pillars of sustainability. Aspects of environmental and economic sustainability have been rigorously researched and practiced and huge volume of strong evidence of effectiveness has been founded for these two sub-areas. For the social and cultural aspects of sustainability, dependable evidence of effectiveness is still to be instituted as the researchers and practitioners are developing and experimenting methods across the globe. Therefore, the present research aimed to identify globally used practices of social and cultural sustainability and through evidence synthesis assess their outcomes to determine the effectiveness of those practices. A PICO format steered the methodology which included all populations, popular sustainability practices including walkability/cycle tracks, social/recreational spaces, privacy, health & human services and barrier free built environment, comparators included ‘Before’ and ‘After’, ‘With’ and ‘Without’, ‘More’ and ‘Less’ and outcomes included Social well-being, cultural co-existence, quality of life, ethics and morality, social capital, sense of place, education, health, recreation and leisure, and holistic development. Search of literature included major electronic databases, search websites, organizational resources, directory of open access journals and subscribed journals. Grey literature, however, was not included. Inclusion criteria filtered studies on the basis of research designs such as total randomization, quasi-randomization, cluster randomization, observational or single studies and certain types of analysis. Studies with combined outcomes were considered but studies focusing only on environmental and/or economic outcomes were rejected. Data extraction, critical appraisal and evidence synthesis was carried out using customized tabulation, reference manager and CASP tool. Partial meta-analysis was carried out and calculation of pooled effects and forest plotting were done. As many as 13 studies finally included for final synthesis explained the impact of targeted practices on health, behavioural and social dimensions. Objectivity in the measurement of health outcomes facilitated quantitative synthesis of studies which highlighted the impact of sustainability methods on physical activity, Body Mass Index, perinatal outcomes and child health. Studies synthesized qualitatively (and also quantitatively) showed outcomes such as routines, family relations, citizenship, trust in relationships, social inclusion, neighbourhood social capital, wellbeing, habitability and family’s social processes. The synthesized evidence indicates slight effectiveness and efficacy of social and cultural sustainability on the targeted outcomes. Further synthesis revealed that such results of this study are due weak research designs and disintegrated implementations. If architects and other practitioners deliver their interventions in collaboration with research bodies and policy makers, a stronger evidence-base in this area could be generated.

Keywords: built environment, cultural sustainability, social sustainability, sustainable architecture

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Authors: Gloria Inés Martínez Domínguez, Lina María Martínez Sánchez, María de los Ángeles Rodríguez Gázquez, Juan Guillermo Jiménez Jiménez, Johan Sebastián Lopera Valle, Natalia Vargas Grisales, Sara Rojas Jiménez, Alejandra Uribe Ocampo, Sara Correa Pérez, Natalia Perilla Hernández, Juan Sebastián Marín Cárdenas

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The relationship between diet and chronic or degenerative diseases has led to the development of functional foods such as nutraceuticals. Objective: To determine the prevalence and characteristics of consumption of nutraceuticals in undergraduate students. Methodology: Cross-sectional study. It was a simple random sampling with the Statcalc EpiInfo software vr 6.04. It was designed an instrument for collection of demographic data and consumption of nutraceuticals. Statistical analysis used the SPSS program. Results: 427 students, average age 20.8 years (SD 3.1), 56.1% were women. The life prevalence of nutraceuticals consumption was 66.3% and the annual 51.8%. The main reasons for consumption were as food complement 32.8% and prevent diseases 20.1%. Conclusion: The high prevalence of nutraceuticals observed is comparable to that reported in the literature, which suggests an increasing trend in the habit of consumption of dietary supplement which have a preventive or protective effect on health.

Keywords: dietary supplements, food, health, functional food, Colombia

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Authors: Ghada M. El-Kassas, Maged A. El Wakeel, Salwa R. El-Zayat

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Background: Environmental enteric dysfunction (EED) is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary omega-3 might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether omega-3 supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: 100 Egyptian stunted children aged 1-5 years and 100 age and gender-matched normal children as controls. At the primary phase of the study, we assessed anthropometric measures and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED). Cognitive development was assessed (Bayley or Wechsler scores). Oral n-3 (omega-3) LC-PUFA at a dosage of 500 mg/d was supplemented to all cases and followed up for 6 months after which the 2ry phase of the study included the previous clinical, laboratory and cognitive assessment. Results: Fecal inflammatory markers were significantly higher in cases compared to controls. (MPO), (NEO) and (AAT) showed a significant decline in cases at the end of the 2ry phase (P < 0.001 for all). Omega-3 supplementation resulted also in a significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both). Cases showed significant improvement of cognitive function at phase 2 of the study. Conclusions: Omega-3 supplementation successfully improved intestinal inflammatory state related to EED. Also, some improvement of anthropometric and cognitive parameters showed obvious improvement with omega-3 supplementation.

Keywords: cognitive functions, EED, omega-3, stunting

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Authors: Kevin Giraldo, Juan A. Gallego, Uriel Zapata, Fanny L. Casado

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Compliant mechanisms are designed to deform in a controlled manner in response to external forces, utilizing the flexibility of their components to store potential elastic energy during deformation, gradually releasing it upon returning to its original form. This article explores the design of a knee orthosis intended to assist users during stand-up motion. The orthosis makes use of a compliant mechanism to balance the user’s weight, thereby minimizing the strain on leg muscles during standup motion. The primary function of the compliant mechanism is to store and exchange potential energy, so when coupled with the gravitational potential of the user, the total potential energy variation is minimized. The design process for the semi-rigid knee orthosis involved material selection and the development of a numerical model for the compliant mechanism seen as a spring. Geometric properties are obtained through the numerical modeling of the spring once the desired stiffness and safety factor values have been attained. Subsequently, a 3D finite element analysis was conducted. The study demonstrates a strong correlation between the maximum stress in the mathematical model (250.22 MPa) and the simulation (239.8 MPa), with a 4.16% error. Both analyses safety factors: 1.02 for the mathematical approach and 1.1 for the simulation, with a consistent 7.84% margin of error. The spring’s stiffness, calculated at 90.82 Nm/rad analytically and 85.71 Nm/rad in the simulation, exhibits a 5.62% difference. These results suggest significant potential for the proposed device in assisting patients with knee orthopedic restrictions, contributing to ongoing efforts in advancing the understanding and treatment of knee osteoarthritis.

Keywords: biomechanics, complaint mechanisms, gonarthrosis, orthoses

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Authors: Noori Shafiqullah

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Millions of people reside downstream of river basins that heavily rely on snowmelt originating from the Hindu Kush (HK) region. Snowmelt plays a critical role as a primary water source in these areas. This study aimed to evaluate snowfall and snowmelt characteristics in the HK region across altitudes ranging from 2019m to 4533m. To achieve this, the study employed a combination of remote sensing techniques and the Snow Model (SM) to analyze the spatial and temporal distribution of Snow Water Equivalent (SWE). By integrating the simulated Snow-cover Area (SCA) with data from the Moderate Resolution Imaging Spectroradiometer (MODIS), the study optimized the Precipitation Gradient (PG), snowfall assessment, and the degree-day factor (DDF) for snowmelt distribution. Ground observed data from various elevations were used to calculate a temperature lapse rate of -7.0 (°C km-1). Consequently, the DDF value was determined as 3 (mm °C-1 d-1) for altitudes below 3000m and 3 to 4 (mm °C-1 d-1) for higher altitudes above 3000m. Moreover, the distribution of precipitation varies with elevation, with the PG being 0.001 (m-1) at lower elevations below 4000m and 0 (m-1) at higher elevations above 4000m. This study successfully utilized the SM to assess SCA and SWE by incorporating the two optimized parameters. The analysis of simulated SCA and MODIS data yielded coefficient determinations of R2, resulting in values of 0.95 and 0.97 for the years 2014-2015, 2015-2016, and 2016-2017, respectively. These results demonstrate that the SM is a valuable tool for managing water resources in mountainous watersheds such as the HK, where data scarcity poses a challenge."

Keywords: improved MODIS, experiment, snow water equivalent, snowmelt

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Authors: Tawfig Falani, Abdulalaziz Saleh

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Air pollution has become a major environmental issue with definitive repercussions on human health. Global concerns have been raised about the health effects of deteriorating air quality due mainly to widespread industrialization and urbanization. To assess the quality of air in Brega, air quality indicators were calculated using the U.S. Environmental Protection Agency procedure. Air quality was monitored from 01/10/2019 to 28/02/2021 with a daily average measuring six pollutants of particulate matter <2.5µm (PM2.5), and <10µm (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO). The result indicated that air pollution at general air quality monitoring sites for sulphur dioxide, carbon monoxide, PM₁₀ and PM2.5 and nitrogen dioxide are always within the permissible limit. Referring to a monthly average of Pollutants in the Brega Industrial area, all months were out of AQG limit for NO₂, and the same with O₃ except for two months. For PM2.5 and PM₁₀ 7, 5 out of 17 months were out of limits, respectively. Relative AQI for ozone is found in the range of moderate category of general air pollution, and the worst month was Nov. 2020, which was marked as Very Unhealthy category, then the next two months (Dec. 2020 and Jan. 2021 ) were Unhealthy categories. It's the first time that we have used the AQI in SOC, and not usually used in Libya to identify the quality of air pollution. So, I think it will be useful if AQI is used as guidance for specified air pollution. That dictate putting monitoring stations beside any industrial activity that has emissions of the six major air pollutants.

Keywords: air quality, air pollutants, air quality index (AQI), particulate matter

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Authors: Larifah Mohd Sidik, Anuar Kasa

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In recent years, the demands for raw water are increasing along with the growth of the economy and population. Hence, the need for the construction and operation of dams is one of the solutions for the management of water resources problems. The stability of the embankment should be taken into consideration to evaluate the safety of retaining water. The safety of the dam is mostly based on numerous measurable components, for instance, seepage flowrate, pore water pressure and deformation of the embankment. Seepage and slope stability is the primary and most important reason to ascertain the overall safety behavior of the dams. This research study was conducted to evaluate static condition seepage and slope stability performances of Batu dam which is located in Kuala Lumpur capital city. The numerical solution Geostudio-2012 software was employed to analyse the seepage using finite element method, SEEP/W and slope stability using limit equilibrium method, SLOPE/W for three different cases of reservoir level operations; normal and flooded condition. Results of seepage analysis using SEEP/W were utilized as parental input for the analysis of SLOPE/W. Sensitivity analysis on hydraulic conductivity of material was done and calibrated to minimize the relative error of simulation SEEP/W, where the comparison observed field data and predicted value were also carried out. In seepage analysis, such as leakage flow rate, pore water distribution and location of a phreatic line are determined using the SEEP/W. The result of seepage analysis shows the clay core effectively lowered the phreatic surface and no piping failure is shown in the result. Hence, the total seepage flux was acceptable and within the permissible limit.

Keywords: earth dam, dam safety, seepage, slope stability, pore water pressure

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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Authors: Jenna Barriault, Reeshma Haji

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Online consumer behaviourand reliance on online reviews may be more pervasive than ever, andthis necessitates a better scientific understanding of the widespread phenomenon of online deception. The present research focuses on the understudied topic of deceiver’s distrust, where those who engage in deception later have less trust in others in the context of online restaurant reviews. The purpose was to examine deception and valence in online restaurant reviews and the effects they had on deceiver’s distrust. Undergraduate university students (N = 76) completed an online study where valence was uniquely manipulated by telling participants that either positive (or negative reviews) were influential and asking them to write a correspondingly valenced review. Deception was manipulated in the same task. Participants in the deception condition were asked to write an online restaurant review that was counter to their actual experience of the restaurant (negative review of a restaurant they liked, positive review of the restaurant they did not like). In the no deception condition, participants were asked to write a review that they actually liked or didn’t like (based on the valence condition to which they were randomly assigned). Participants’ trust was then assessed through various measures, includingfuture reliance on online reviews. There was a main effect of deception on reliance on online reviews. Consistent with deceiver’s distrust, those who deceived reported that they would rely less on online reviews. This study demonstrates that even when participants are induced to write a deceptive review, it can result in deceiver’s distrust, thereby lowering their trust in online reviews. If trust or reliance can be altered through deception in online reviews, people may start questioning the objectivity or true representation of a company based on such reviews. A primary implication is that people may reduce theirreliance upon online reviews if they know they are easily subject to manipulation. The findings of this study also contribute to the limited research regarding deceiver’s distrust in an online context, and further research is clarifying the specific conditions in which it is most likely to occur.

Keywords: deceiver’s distrust, deception, online reviews, trust, valence

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Authors: Amira ben Hassine, A. Valverde, V. Serafín, C. Muñoz-San Martín, M. Garranzo-Asensio, M. Gamella, R. Barderas, M. Pedrero, N. Raouafi, S. Campuzano, P. Yáñez-Sedeño, J. M. Pingarrón

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This work describes the development of a dual electrochemical immunosensing platform for accurate determination of two target proteins, IL-13 Receptor α2 (IL-13Rα2) and E-cadherin (E-cad). The proposed methodology is based on the use of sandwich immunosensing approaches (involving horseradish peroxidase-labeled detector antibodies) implemented onto magnetic microbeads (MBs) and amperometric transduction at screen-printed dual carbon electrodes (SPdCEs). The magnetic bioconjugates were captured onto SPdCEs and the amperometric transduction was performed using the H2O2/hydroquinone (HQ) system. Under optimal experimental conditions, the developed bio platform demonstrates linear concentration ranges of 1.0–25 and 5.0-100 ng mL-1, detection limits of 0.28 and 1.04 ng mL-1 for E-cad and IL-13Rα2, respectively, and excellent selectivity against other non-target proteins. The developed immuno-platform also offers a good reproducibility among amperometric responses provided by nine different sensors constructed in the same manner (Relative Standard Deviation values of 3.1% for E-cad and 4.3% for IL-13Rα2). Moreover, obtained results confirm the practical applicability of this bio-platform for the accurate determination of the endogenous levels of both extracellular receptors in colon cancer cells (both intact and lysed) with different metastatic potential and serum and tissues from patients diagnosed with colorectal cancer at different grades. Interesting features in terms of, simplicity, speed, portability and sample amount required to provide quantitative results, make this immuno-platform more compatible than conventional methodologies with the clinical diagnosis and prognosis at the point of care.

Keywords: electrochemistry, mmunosensors, biosensors, E-cadherin, IL-13 receptor α2, cancer colorectal

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Authors: Germán Díaz Flórez, Carlos Alberto Olvera Olvera, Domingo José Gómez Meléndez, Francisco Eneldo López Monteagudo

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In recent decades, population growth has exerted great pressure on natural resources. Two of the most scarce and difficult to obtain resources, arable land, and water, are closely interrelated, to the satisfaction of the demand for food production. In Mexico, the agricultural sector uses more than 70% of water consumption. Therefore, maximize the efficiency of current production systems is inescapable. It is essential to utilize techniques and tools that will enable us to the significant savings of water, labor and fertilizer. In this study, we present a production module of hydroponic green forage (HGF), which is a viable alternative in the production of livestock feed in the semi-arid and arid zones. The equipment in addition to having a forage production module, has a climate and irrigation control system that operated with photovoltaics. The climate control, irrigation and power management is based on fuzzy control techniques. The fuzzy control provides an accurate method in the design of controllers for nonlinear dynamic physical phenomena such as temperature and humidity, besides other as lighting level, aeration and irrigation control using heuristic information. In this working, firstly refers to the production of the hydroponic green forage, suitable weather conditions and fertigation subsequently presents the design of the production module and the design of the controller. A simulation of the behavior of the production module and the end results of actual operation of the equipment are presented, demonstrating its easy design, flexibility, robustness and low cost that represents this equipment in the primary sector.

Keywords: fuzzy, climate control system, hydroponic green forage, forage production module

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Authors: Md. Reduanul Haque

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In recent time, more and more refugees are emerging in the international arena than the times ever that has come into the notice of world scholars. The prevailing customary solutions such as voluntary repatriation, local integration, and resettlement of refugee problem have been reflected unsustainable one for the lack of regional cooperation. In the international arena, the protraction of refugee problems is seen, and refugees are suffering due to the outrageous process of customary refugee solutions. If the regional cooperation can be developed, then the suffering of the refugees can be mitigated by the contribution of neighboring country and international and regional organizations. Data collected from the various secondary sources have been used throughout the research. It has been discussing in the refugee academia for a long time to develop regional cooperation mechanisms to ensure the sustainability of this solution and to make the environment of the country of origin for suitable voluntary repatriation as well as a durable solution. It is mainly qualitative research based on primary and secondary data will be studied on library-based project. Data collected by such methodology on this study indicates to make a bridge between the gaps of the cooperation mechanism and to make a more regional approach to share the burden and to strengthen the customary refugee solution. Hence, the importance of questing for a regional mechanism is to ensure the responsible countries to be more responsible towards refugees, their human rights, and durable solution under the mandate of the UNHCR. To implement effectively all the customary durable solutions, country to country or regional organization to organization based regional cooperation can be developed where the countries and regional organizations will work together to draw a sustainable solution to this problem in international context.

Keywords: refugee, regional cooperation, sustainable implementation, customary solutions, international arena

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Authors: Omer Shujat Bhatti, Afshan Huma

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Online educational system were considered a great opportunity for distance learning. In recent days of COVID19 pandemic, it enable the continuation of educational activities at all levels of education, from primary school to the top level universities. One of the key considered element in supporting the online educational system is video lectures. The current research explored the usefulness of the video lectures delivered to technical students of masters level with a focus on MSc Sustainable Environmental design students who have diverse backgrounds in the formal educational system. Hence they were unable to cope right away with the online system and faced communication and understanding issues in the lecture session due to internet and allied connectivity issues. Researcher used self prepared video lectures for respective subjects and provided them to the students using Youtube channel and subject based Whatsapp groups. Later, students were asked about the usefulness of the lectures towards a better understanding of the subject and an overall enhanced learning experience. More than 80% of the students appreciated the effort and requested it to be part of the overall system. Data collection was done using an online questionnaire which was prior briefed to the students with the purpose of research. It was concluded that video lectures should be considered an integral part of the lecture sessions and must be provided prior to the lecture session, ensuring a better quality of delivery. It was also recommended that the existing system must be upgraded to support the availability of these video lectures through the portal. Teachers training must be provided to help develop quality video content ensuring that is able to cover the content and courses taught.

Keywords: video lectures, online distance education, synchronous instruction, asynchronous communication

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Authors: Alilu Getahun Sulito

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Exceptional floods are now prevalent in many places in Ethiopia, resulting in a large number of human deaths and property destruction. Lake Boyo watershed, in particular, had also traditionally been vulnerable to flash floods throughout the Boyo watershed. The goal of this research is to create flood and inundation maps for the Boyo Catchment. The integration of Geographic information system(GIS) technology and the hydraulic model (HEC-RAS) were utilized as methods to attain the objective. The peak discharge was determined using Fuller empirical methodology for intervals of 5, 10, 15, and 25 years, and the results were 103.2 m3/s, 158 m3/s, 222 m3/s, and 252 m3/s, respectively. River geometry, boundary conditions, manning's n value of varying land cover, and peak discharge at various return periods were all entered into HEC-RAS, and then an unsteady flow study was performed. The results of the unsteady flow study demonstrate that the water surface elevation in the longitudinal profile rises as the different periods increase. The flood inundation charts clearly show that regions on the right and left sides of the river with the greatest flood coverage were 15.418 km2 and 5.29 km2, respectively, flooded by 10,20,30, and 50 years. High water depths typically occur along the main channel and progressively spread to the floodplains. The latest study also found that flood-prone areas were disproportionately affected on the river's right bank. As a result, combining GIS with hydraulic modelling to create a flood inundation map is a viable solution. The findings of this study can be used to care again for the right bank of a Boyo River catchment near the Boyo Lake kebeles, according to the conclusion. Furthermore, it is critical to promote an early warning system in the kebeles so that people can be evacuated before a flood calamity happens. Keywords: Flood, Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Keywords: Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Procedia PDF Downloads 44

Authors: Daniel Zarzo Montes, Manuel Zarzo Castelló

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Proteins play a fundamental role in biology, but their structure is complex, and it is a challenge for teachers to conceptually explain the differences between their primary, secondary, tertiary, and quaternary structures. On the other hand, there are currently many computer programs to visualize the 3D structure of proteins, but they require advanced training and knowledge. Moreover, it becomes difficult to visualize the sequence of amino acids in these models, and how the protein conformation is reached. Given this drawback, a simple and instructive procedure is proposed in order to teach the protein structure to undergraduate and graduate students. For this purpose, insulin has been chosen because it is a protein that consists of 51 amino acids, a relatively small number. The methodology has consisted of the use of plastic atom models, which are frequently used in organic chemistry and biochemistry to explain the chirality of biomolecules. For didactic purposes, when the aim is to teach the biochemical foundations of proteins, a manipulative system seems convenient, starting from the chemical structure of amino acids. It has the advantage that the bonds between amino acids can be conveniently rotated, following the pattern marked by the 3D models. First, the 51 amino acids were modeled, and then they were linked according to the sequence of this protein. Next, the three disulfide bonds that characterize the stability of insulin have been established, and then the alpha-helix structure has been formed. In order to reach the tertiary 3D conformation of this protein, different interactive models available on the Internet have been visualized. In conclusion, the proposed methodology seems very suitable for biology and biochemistry students because they can learn the fundamentals of protein modeling by means of a manipulative procedure as a basis for understanding the functionality of proteins. This methodology would be conveniently useful for a biology or biochemistry laboratory practice, either at the pre-graduate or university level.

Keywords: protein structure, 3D model, insulin, biomolecule

Procedia PDF Downloads 48

Authors: A. O. Ogunkeyede, D. Amuchi, A. A. Adebayo

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Heavy metal contaminations in soil have received great attention. Anthropogenic activities such as vehicular emission, industrial activities and constructions have resulted in elevated concentration of heavy metals in the surface soils. The metal particles can be free from the surface soil when they are disturbed and re-entrained in air, which necessitated the need to investigate surface soil at market environment where adults and children are present on daily basis. This study assesses concentration of heavy metal pollution, ecological and health risk factors in surface soil at Effurun market. 8 samples were collected at household material (EMH), fish (EMFs), fish and commodities (EMF-C), Abattoir (EMA 1 & 2), fruit sections (EMF 1 & 2) and lastly main road (EMMR). The samples were digested and analyzed in triplicate for contents of Lead (Pb), Nickel (Ni), Cadmium (Cd) and Copper (Cu). The mean concentration of the Pb mg/kg (112.27 ± 1.12) and Cu mg/kg (156.14 ± 1.10) were highest in the abattoir section (EMA 1). The mean concentrations of the heavy metal were then used to calculate the ecological and health risk for people within the market. Pb contamination at EMMR, EMF 2, EMFs were moderately while Pb shows considerable contamination at EMH, EMA 1, EMA 2 and EMF-C sections of the Effurun market. The ecological risk factor varies between low to moderate pollution for Pb and EMA 1 has the highest potential ecological risk that falls within moderate pollution. The hazard quotient results show that dermal exposure pathway is the possible means of heavy metal exposure to the traders while ingestion is the least sources of exposure to adult. The ingestion suggested that children around the EMA 1 have the highest possible exposure to children due to hand-to-mouth and object-to-mouth behaviour. The results further show that adults at the EMA1 will have the highest exposure to Pb due to inhalation during burning of cow with tyre that contained Pb and Cu. The carcinogenic risk values of most sections were higher than acceptable values, while Ni at EMMR, EMF 1 & 2, EMFs and EMF-C sections that were below the acceptable values. The cancer risk for inhalation exposure pathway for Pb (1.01E+17) shows a significant level of contamination than all the other sections of the market. It suggested that the people working at the Abattoir were very prone to cancer risk.

Keywords: carcinogenic, ecological, heavy metal, risk

Procedia PDF Downloads 138

Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

Procedia PDF Downloads 40

Authors: Monika Yadav

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The incorporation of a healthy lifestyle significantly contributes to the advancement of economic development. Urbanization, industrialization, and economic growth have enhanced living conditions, promoting sedentary behaviours among individuals with elevated socio-economic statuses. The prevalence of overweight and obesity has increased globally, along with the rise in living standards, posing a growing health risk. Overweight and obesity are known to be precursors to a range of modifiable and metabolic risk factors, contributing to the increase in lifestyle diseases. Unhealthy dietary choices and lifestyle practices primarily drive these diseases. Lifestyle diseases refer to chronic and non-communicable illnesses, encompassing conditions such as hypertension, heart disease, kidney disorders, infertility, polycystic ovary syndrome (PCOD), diabetes, respiratory diseases, and certain forms of cancer. This study examines the prevalence of lifestyle diseases among urban Indian women, explicitly differentiating between individuals with normal weight and those classified as obese. The main aim of this study is to investigate whether there is a correlation between a higher body mass index (BMI) in women and an increased vulnerability to lifestyle diseases when compared to women with a normal BMI. This research provides insights into the intricate relationship between lifestyle, health, and economic development within urban areas.

Keywords: urbanization, economic development, BMI, NCDs, urban, women, lifestyle practices

Procedia PDF Downloads 61

Authors: Bar Shapira-Youngster, Sima Amram-Vaknin, Yuliya Lipshits-Braziler

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The study examined how 811 Israelis experienced and coped with the COVID-19 lockdown. Stress, uncertainty, and loss of control were reported as common emotional experiences. Two main difficulties were reported: Loneliness and health and emotional concerns. Frequent explanations for the virus's emergence were: scientific or faith reasoning. The most prevalent coping strategies were distraction activities and acceptance. Reducing the use of maladaptive coping strategies has important implications for mental health outcomes. Objectives: COVID-19 has been recognized as a collective, continuous traumatic stressor. The present study examined how individuals experienced, perceived, and coped with this traumatic event during the lockdown in Israel in April 2020. Method: 811 Israelis (71.3% were women; mean age 43.7, SD=13.3)completed an online semi-structured questionnaire consisting two sections: In the first section, participants were asked to report background information. In the second section, they were asked to answer 8 open-ended questions about their experience, perception, and coping with the covid-19 lockdown. Participation was voluntary, and anonymity was assured, they were not offered compensation of any kind. The data were subjected to qualitative content analysis that seeks to classify the participants` answers into an effective number of categories that represent similar meanings. Our content analysis of participants’ answers extended far beyond simple word counts; our objective was to try to identify recurrent categories that characterized participants’ responses to each question. We sought to ensure that the categories regarding the different questions are as mutually exclusive and exhaustive as possible. To ensure robust analysis, the data were initially analyzed by the first author, and a second opinion was then sought from research colleagues. Contribution: The present research expands our knowledge of individuals' experiences, perceptions, and coping mechanisms with continuous traumatic events. Reducing the use of maladaptive coping strategies has important implications for mental health outcomes.

Keywords: Covid-19, emotional distress, coping, continuous traumatic event

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Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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Authors: Paul Saah, Charles Mbohwa, Nelson Sizwe Madonsela

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In the context of developing countries, this study explores a crucial component of economic development by examining the reasons behind the failure of small and medium-sized enterprises (SMEs). SMEs are acknowledged as essential drivers of economic expansion, job creation, and poverty alleviation in emerging countries. This research uses South Africa as a case study to evaluate the reasons why SMEs fail in developing nations. This study explores a quantitative research methodology to investigate the complex causes of SME failures using statistical tools and reliability tests. To ensure the viability of data collection, a sample size of 400 small business owners was chosen using a non-probability selection technique. A closed-ended questionnaire was the primary technique used to obtain detailed information from the participants. Data was analysed and interpreted using computer software packages such as the Statistical Package for the Social Sciences (SPSS). According to the findings, the main reasons why SMEs fail in developing nations are a lack of strategic business planning, a lack of funding, poor management, a lack of innovation, a lack of business research and a low level of education and training. The results of this study show that SMEs can be sustainable and successful as long as they comprehend and use the suggested small business success determining variables into their daily operations. This implies that the more SMEs in developing countries implement the proposed determinant factors of small business success in their business operations the more the businesses are likely to succeed and vice versa.

Keywords: failure, developing countries, SMEs, economic development, South Africa

Procedia PDF Downloads 69

Authors: Swati Bhasin, Ali Ahmed, Valence Xavier, Ben Liu

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Aims: Diarrhea is a problem that is a frequent clinic referral to the gastroenterology and surgical team from the General practitioner. To establish a diagnosis, these patients undergo colonoscopy. The current practice at our district general hospital is to perform random left and right colonic biopsies. National guidelines issued by the British Society of Gastroenterology advise all patients presenting with chronic diarrhea should have an Ileoscopy as an indicator for colonoscopy completion. Our primary aim was to check if Terminal ileum (TI) biopsy is required to establish a diagnosis of inflammatory bowel disease (IBD). Methods: Data was collected retrospectively from November 2018 to November 2019. The target population were patients who underwent colonoscopies for diarrhea. Demographic data, endoscopic and histology findings of TI were assessed and analyzed. Results: 140 patients with a mean age of 57 years (19-84) underwent a colonoscopy (M: F; 1:2.3). 92 patients had random colonic biopsies taken and based on the histological results of these, 15 patients (16%) were diagnosed with IBD. The TI was successfully intubated in 40 patients, of which 32 patients had colonic biopsies taken as well. 8 patients did not have a colonic biopsy taken. Macroscopic abnormality in the TI was detected in 5 patients, all of whom were biopsied. Based on histological results of the biopsy, 3 patients (12%) were diagnosed with IBD. These 3 patients (100%) also had colonic biopsies taken simultaneously and showed inflammation. None of the patients had a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were not done). None of the patients has a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were negative). Conclusion: TI intubation is a highly-skilled, time-consuming procedure with a higher risk of perforation, which as per our study, has little additional diagnostic value in finding IBD for symptoms of diarrhea if colonic biopsies are taken. We propose that diarrhea is a colonic symptom; therefore, colonic biopsies are positive for inflammation if the diarrhea is secondary to IBD. We conclude that all of the IBDs can be diagnosed simply with colonic biopsies.

Keywords: biopsy, colon, IBD, terminal ileum

Procedia PDF Downloads 118