Search results for: interlock protocol
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1128

Search results for: interlock protocol

408 A Study of Influence of Freezing on Mechanical Properties of Tendon Fascicles

Authors: Martyna Ekiert, Andrzej Mlyniec

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Tendons are the biological structures, which primary function is to transfer force generated by muscles to the bones. Unfortunately, damages of tendons are also one of the most common injuries of the human musculoskeletal system. For the most severe cases of tendon rupture, such as the tear of calcaneus tendon or anterior cruciate ligament of the knee, a surgical procedure is the only possible way of full recovery. Tendons used as biological grafts are usually subjected to the process of deep freezing and subsequent thawing. This, in particular for multiple freezing/thawing cycles, may result in changes of tendon internal structure causing deterioration of mechanical properties of the tissue. Therefore, studies on the influence of freezing on tendons biomechanics, including internal water content in soft tissue, seems to be greatly needed. An experimental study of the influence of freezing on mechanical properties of the tendon was performed on fascicles samples dissected form bovine flexor tendons. The preparation procedure was performed with the presence of 0.9% saline solution in order to prevent an excessive tissue drying. All prepared samples were subjected to the different number of freezing/thawing cycles. For freezing part of the protocol we used -80°C temperature while for slow thawing we used fridge temperature (4°C) combined with equalizing temperatures in the standard state (25°C). After final thawing, the mechanical properties of each sample was examined using cyclic loading test. Our results may contribute for better understanding of negative effects of soft tissues freezing, resulting from abnormal thermal expansion of water. This also may help to determine the limit of freezing/thawing cycles disqualifying tissue for surgical purposes and thus help optimize tissues storage conditions.

Keywords: freezing, soft tissue, tendon, bovine fascicles

Procedia PDF Downloads 219
407 In Situ Volume Imaging of Cleared Mice Seminiferous Tubules Opens New Window to Study Spermatogenic Process in 3D

Authors: Lukas Ded

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Studying the tissue structure and histogenesis in the natural, 3D context is challenging but highly beneficial process. Contrary to classical approach of the physical tissue sectioning and subsequent imaging, it enables to study the relationships of individual cellular and histological structures in their native context. Recent developments in the tissue clearing approaches and microscopic volume imaging/data processing enable the application of these methods also in the areas of developmental and reproductive biology. Here, using the CLARITY tissue procedure and 3D confocal volume imaging we optimized the protocol for clearing, staining and imaging of the mice seminiferous tubules isolated from the testes without cardiac perfusion procedure. Our approach enables the high magnification and fine resolution axial imaging of the whole diameter of the seminiferous tubules with possible unlimited lateral length imaging. Hence, the large continuous pieces of the seminiferous tubule can be scanned and digitally reconstructed for the study of the single tubule seminiferous stages using nuclear dyes. Furthermore, the application of the antibodies and various molecular dyes can be used for molecular labeling of individual cellular and subcellular structures and resulting 3D images can highly increase our understanding of the spatiotemporal aspects of the seminiferous tubules development and sperm ultrastructure formation. Finally, our newly developed algorithms for 3D data processing enable the massive parallel processing of the large amount of individual cell and tissue fluorescent signatures and building the robust spermatogenic models under physiological and pathological conditions.

Keywords: CLARITY, spermatogenesis, testis, tissue clearing, volume imaging

Procedia PDF Downloads 136
406 Evaluation of Genetic Resistance to Haemonchus Contortus in Teddy and Beetal Goat Breeds of Punjab, Pakistan

Authors: Muhammad S. Sajid, Asim Shamim, Muhammad Nisar Khan, Ashfaq A. Chatta, Muhammad Saqib

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Goats (Capra hircus) are a valued asset for resource poor farmers globally. But the parasitic infection especially Haemonchus contortus (Trichostrongylid), impact the health and production of goats globally. The present study intended to evaluate resilient and resistance to Haemonchus contortus in indigenous goat breeds (Teddy and Beetal) of Punjab, Pakistan. Out of 60, 30 goats of each breed were divided into 6 groups and each group contain five goats. Two group of each breed received challenged infection with 12000 and 18000 L3 (third stage) larvae of Haemonchus contortus under two infection protocol that is early and trickle and remaining two group of each breed was kept as control. Resilient and resistance of each breed was then measured on the basis of their phenotypic markers like: faecal egg counts, packed cell volume, FAMACHA score system, body weight, total protein, albumin and worm count on 2nd, 4th, 6th, and 8th week of post infection. Variation in response of each goat breeds to Haemonchus contortus was observed. Teddy breed showed significant (P < 0.05)resistance as compared to Beetal. It is probably first attempt to report an evaluation of goat breed response towards Haemonchus contortus in Pakistan. It was concluded that Teddy goats have a greater genetic tendency to resist against to the Haemonchus contortus infection and this breed could be kept and bred from the economic point of view. Evaluation of genetic markers are like: gene, protein expression, Immunoglobulin, Histamines and interleukins determination are recommended for future studies which can be helpful to be fined resistant breed of goats.

Keywords: goat, beetal, teddy, haemonchus contortus, resistance, resilience, phenotypic markers

Procedia PDF Downloads 361
405 Online Monitoring of Airborne Bioaerosols Released from a Composting, Green Waste Site

Authors: John Sodeau, David O'Connor, Shane Daly, Stig Hellebust

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This study is the first to employ the online WIBS (Waveband Integrated Biosensor Sensor) technique for the monitoring of bioaerosol emissions and non-fluorescing “dust” released from a composting/green waste site. The purpose of the research was to provide a “proof of principle” for using WIBS to monitor such a location continually over days and nights in order to construct comparative “bioaerosol site profiles”. Current impaction/culturing methods take many days to achieve results available by the WIBS technique in seconds.The real-time data obtained was then used to assess variations of the bioaerosol counts as a function of size, “shape”, site location, working activity levels, time of day, relative humidity, wind speeds and wind directions. Three short campaigns were undertaken, one classified as a “light” workload period, another as a “heavy” workload period and finally a weekend when the site was closed. One main bioaerosol size regime was found to predominate: 0.5 micron to 3 micron with morphologies ranging from elongated to elipsoidal/spherical. The real-time number-concentration data were consistent with an Andersen sampling protocol that was employed at the site. The number-concentrations of fluorescent particles as a proportion of total particles counted amounted, on average, to ~1% for the “light” workday period, ~7% for the “heavy” workday period and ~18% for the weekend. The bioaerosol release profiles at the weekend were considerably different from those monitored during the working weekdays.

Keywords: bioaerosols, composting, fluorescence, particle counting in real-time

Procedia PDF Downloads 355
404 Influence of Organic Supplements on Shoot Multiplication Efficiency of Phaius tankervilleae var. alba

Authors: T. Punjansing, M. Nakkuntod, S. Homchan, P. Inthima, A. Kongbangkerd

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The influence of organic supplements on growth and multiplication efficiency of Phaius tankervilleae var. alba seedlings was investigated. 12 week-old seedlings were cultured on half-strength semi-solid Murashige and Skoog (MS) medium supplemented with 30 g/L sucrose, 8 g/L agar and various concentrations of coconut water (0, 50, 100, 150 and 200 mL/L) combined with potato extract (0, 25 and 50 g/L) and the pH was adjusted to 5.8 prior to autoclaving. The cultures were then kept under constant photoperiod (16 h light: 8 h dark) at 25 ± 2 °C for 12 weeks. The highest number of shoots (3.0 shoots/explant) was obtained when cultured on the medium added with 50 ml/L coconut water and 50 g/L potato extract whereas the highest number of leaves (5.9 leaves/explant) and roots (6.1 roots/explant) could receive on the medium supplemented with 150 ml/L coconut water and 50 g/L potato extract. with 150 ml/L coconut water and 50 g/L potato extract. Additionally, plantlets of P. tankervilleae var. alba were transferred to grow into seven different substrates i.e. soil, sand, coconut husk chip, soil-sand mix (1: 1), soil-coconut husk chip mix (1: 1), sand-coconut husk chip mix (1: 1) and soil-sand-coconut husk chip mix (1: 1: 1) for four weeks. The results found that acclimatized plants showed 100% of survivals when sand, coconut husk chip and sand-coconut husk chip mix are used as substrates. The number of leaves induced by sand-coconut husk chip mix was significantly higher than that planted in other substrates (P > 0.05). Meanwhile, no significant difference in new shoot formation among these substrates was observed (P < 0.05). This precursory developing protocol was likely to be applied for more large scale of plant production as well as conservation of germplasm of this orchid species.

Keywords: organic supplements, acclimatization, Phaius tankervilleae var. alba, orchid

Procedia PDF Downloads 229
403 The Benefit of a Universal Screening Program for Lipid Disorders in Two to Ten Years Old Lebanese Children

Authors: Nicolas Georges, Akiki Simon, Bassil Naim, Nawfal Georges, Abi Fares Georges

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Introduction: Dyslipidemia has been recognized as a risk factor for cardiovascular diseases. While the development of atherosclerotic lesions begins in childhood and progresses throughout life, data on the prevalence of dyslipidemic children in Lebanon is lacking. Objectives: This study was conducted to assess the benefit of a protocol for universal screening for lipid disorder in Lebanese children aged between two and ten years old. Materials and Methods: A total of four hundred children aged 2 to 10 years old (51.5% boys) were included in the study. The subjects were recruited from private pediatric clinics after parental consent. Fasting total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) levels were measured and non-HDL cholesterol was calculated. The values were categorized according to 2011 Expert on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Results: The overall prevalence of high TC ( ≥ 200 mg/dL), high non-HDL-C ( ≥ 145 mg/dL), high LDL ( ≥ 130 mg/dL), high TG ( ≥ 100 mg/dL) and low HDL ( < 40 mg/dL) was respectively 19.5%, 23%, 19%, 31.8% and 20%. The overall frequency of dyslipidemia was 51.7%. In a bivariate analysis, dyslipidemia in children was associated with a BMI ≥ 95ᵗʰ percentile and parents having TC > 240 mg/dL with a P value respectively of 0.006 and 0.0001. Furthermore, high TG was independently associated with a BMI ≥ 95ᵗʰ percentile (P=0.0001). Children with parents having TC > 240 mg/dL was significantly correlated with high TC, high non-HDL-C and high LDL (P=0.0001 for all variables). Finally, according to the Pediatric dyslipidemia screening guidelines from the 2011 Expert Panel, 62.3% of dyslipidemic children had at least 1 risk factor that qualified them for screening while 37.7% of them didn’t have any risk factor. Conclusions: It is preferable to review the latest pediatric dyslipidemia screening guidelines by performing a universal screening program since a third of our dyslipidemic Lebanese children have been missed.

Keywords: cardiovascular risk factors, dyslipidemia, Lebanese children, screening

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402 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations during the First 9 Months

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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401 In a Situation of Great Distress: Cross Border Migration and the Quest for Enduring Security in North-East Nigeria

Authors: Nuhu Bitrus Mailabari

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Nigeria is a highly multifarious nation trapped between affluence and affliction. On one hand, the state has vast territorial size, economic strength, relative internal cohesion, and good external linkages. On the other, it is bedeviled with enormous challenges. It is common knowledge that the North-East geo-political zone has suffered colossal destruction for the most part of the last ten years due to the activities of the insurgent group Boko Haram. Several factors (political, economic, religious, socio-cultural) have been credited with the heightened insecurity in the region. Without a doubt, the security crisis in the region has rekindled several discussions critical to Nigeria’s security architecture. However, the debate on finding an enduring solution to the devastation in the North East continually neglects the nexus between cross border migration and national security. Using content analysis, this paper debates two main issues that continue to affect security in the North East. One, the cumulative impact of the Economic Community of West African States (ECOWAS) protocol on the free movement of people and goods. Two, the porous nature of Nigeria’s borders. Theoretically, the paper will rely on the systems theory because of its broad focus on structure, linkage, and process. The work concludes in twofold. First, that cross border migration and poor border management processes further worsened the political and socio-economic conditions of a region that is already in a bad state. Secondly, in addition to the existing strategies, Nigeria must develop a holistic approach including new methods of handling cross border movements in solving the security issues.

Keywords: border, cross border, migration, Nigeria, northeast region, security

Procedia PDF Downloads 164
400 Development of an Aerosol Protection Capsule for Patients with COVID-19

Authors: Isomar Lima da Silva, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Biological isolation capsules are equipment commonly used in the control and prevention of infectious diseases in the hospital environment. This type of equipment, combined with pre-established medical protocols, contributes significantly to the containment of highly transmissible pathogens such as COVID-19. Due to its hermetic isolation, it allows more excellent patient safety, protecting companions and the health team. In this context, this work presents the development, testing, and validation of a medical capsule to treat patients affected by COVID-19. To this end, requirements such as low cost and easy handling were considered to meet the demand of people infected with the virus in remote locations in the Amazon region and/or where there are no ICU beds and mechanical ventilators for orotracheal intubation. Conceived and developed in a partnership between SAMEL Planos de Saúde and Instituto Conecthus, the device entitled "Vanessa Capsule" was designed to be used together with the NIV protocol (non-invasive ventilation), has an automatic exhaust system and filters performing the CO2 exchange, in addition to having BiPaps ventilatory support equipment (mechanical fans) in the Cabin Kit. The results show that the degree of effectiveness in protecting against infection by aerosols, with the protection cabin, is satisfactory, implying the consideration of the Vanessa capsule as an auxiliary method to be evaluated by the health team. It should also be noted that the medical observation of the evaluated patients found that the treatment against the COVID-19 virus started earlier with non-invasive mechanical ventilation reduces the patient's suffering and contributes positively to their recovery, in association with isolation through the Vanessa capsule.

Keywords: COVID-19, mechanical ventilators, medical capsule, non-invasive ventilation

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399 Integration of an Augmented Reality System for the Visualization of the HRMAS NMR Analysis of Brain Biopsy Specimens Using the Brainlab Cranial Navigation System

Authors: Abdelkrim Belhaoua, Jean-Pierre Radoux, Mariana Kuras, Vincent Récamier, Martial Piotto, Karim Elbayed, François Proust, Izzie Namer

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This paper proposes an augmented reality system dedicated to neurosurgery in order to assist the surgeon during an operation. This work is part of the ExtempoRMN project (Funded by Bpifrance) which aims at analyzing during a surgical operation the metabolic content of tumoral brain biopsy specimens by HRMAS NMR. Patients affected with a brain tumor (gliomas) frequently need to undergo an operation in order to remove the tumoral mass. During the operation, the neurosurgeon removes biopsy specimens using image-guided surgery. The biopsy specimens removed are then sent for HRMAS NMR analysis in order to obtain a better diagnosis and prognosis. Image-guided refers to the use of MRI images and a computer to precisely locate and target a lesion (abnormal tissue) within the brain. This is performed using preoperative MRI images and the BrainLab neuro-navigation system. With the patient MRI images loaded on the Brainlab Cranial neuro-navigation system in the operating theater, surgeons can better identify their approach before making an incision. The Brainlab neuro-navigation tool tracks in real time the position of the instruments and displays their position on the patient MRI data. The results of the biopsy analysis by 1H HRMAS NMR are then sent back to the operating theater and superimposed on the 3D localization system directly on the MRI images. The method we have developed to communicate between the HRMAS NMR analysis software and Brainlab makes use of a combination of C++, VTK and the Insight Toolkit using OpenIGTLink protocol.

Keywords: neuro-navigation, augmented reality, biopsy, BrainLab, HR-MAS NMR

Procedia PDF Downloads 363
398 A QoS Aware Cluster Based Routing Algorithm for Wireless Mesh Network Using LZW Lossless Compression

Authors: J. S. Saini, P. P. K. Sandhu

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The multi-hop nature of Wireless Mesh Networks and the hasty progression of throughput demands results in multi- channels and multi-radios structures in mesh networks, but the main problem of co-channels interference reduces the total throughput, specifically in multi-hop networks. Quality of Service mentions a vast collection of networking technologies and techniques that guarantee the ability of a network to make available desired services with predictable results. Quality of Service (QoS) can be directed at a network interface, towards a specific server or router's performance, or in specific applications. Due to interference among various transmissions, the QoS routing in multi-hop wireless networks is formidable task. In case of multi-channel wireless network, since two transmissions using the same channel may interfere with each other. This paper has considered the Destination Sequenced Distance Vector (DSDV) routing protocol to locate the secure and optimised path. The proposed technique also utilizes the Lempel–Ziv–Welch (LZW) based lossless data compression and intra cluster data aggregation to enhance the communication between the source and the destination. The use of clustering has the ability to aggregate the multiple packets and locates a single route using the clusters to improve the intra cluster data aggregation. The use of the LZW based lossless data compression has ability to reduce the data packet size and hence it will consume less energy, thus increasing the network QoS. The MATLAB tool has been used to evaluate the effectiveness of the projected technique. The comparative analysis has shown that the proposed technique outperforms over the existing techniques.

Keywords: WMNS, QOS, flooding, collision avoidance, LZW, congestion control

Procedia PDF Downloads 338
397 In vitro Skin Model for Enhanced Testing of Antimicrobial Textiles

Authors: Steven Arcidiacono, Robert Stote, Erin Anderson, Molly Richards

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There are numerous standard test methods for antimicrobial textiles that measure activity against specific microorganisms. However, many times these results do not translate to the performance of treated textiles when worn by individuals. Standard test methods apply a single target organism grown under optimal conditions to a textile, then recover the organism to quantitate and determine activity; this does not reflect the actual performance environment that consists of polymicrobial communities in less than optimal conditions or interaction of the textile with the skin substrate. Here we propose the development of in vitro skin model method to bridge the gap between lab testing and wear studies. The model will consist of a defined polymicrobial community of 5-7 commensal microbes simulating the skin microbiome, seeded onto a solid tissue platform to represent the skin. The protocol would entail adding a non-commensal test organism of interest to the defined community and applying a textile sample to the solid substrate. Following incubation, the textile would be removed and the organisms recovered, which would then be quantitated to determine antimicrobial activity. Important parameters to consider include identification and assembly of the defined polymicrobial community, growth conditions to allow the establishment of a stable community, and choice of skin surrogate. This model could answer the following questions: 1) is the treated textile effective against the target organism? 2) How is the defined community affected? And 3) does the textile cause unwanted effects toward the skin simulant? The proposed model would determine activity under conditions comparable to the intended application and provide expanded knowledge relative to current test methods.

Keywords: antimicrobial textiles, defined polymicrobial community, in vitro skin model, skin microbiome

Procedia PDF Downloads 137
396 Determining the Effect of Tdcs in Pain and Quality of Life in Patients with Fibromyalgia

Authors: Farid Rezaei, Zahra Reza Soltani, Behrouz Tavana, Afsaneh Dadarkhah, Masoume Bahrami Asl, S. Alireza Mirghasemi

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Introduction: Fibromyalgia is a syndrome comprised of a group of symptoms. The primary symptom of fibromyalgia is pain propagation is associated by Secondary symptoms include fatigue, cognitive disorders, sleep disorders and hypersensitivity to painful stimuli. Recent studies have shown that there is a direct relationship between fibromyalgia and certain changes in brain activity. Aim: The aim of this study is determining the effect of tDCS in pain and quality of life in patients with fibromyalgia. Method: 68 patients with fibromyalgia who had inclusion criterias were randomly divided into two groups of case and control. Groups were matched in terms of gender, age, education, duration of pain and PMS. Patient groups treated with tDCS device manufacture by Enraf company made in Netherlands (M1 anodal stimulation, 2 mA constant current, 20 minutes, for 10 sessions (3 days a week)). Also the protocol was done for control group, in sham mode of tDCS device that had no current, for 10 sessions of 20 minutes. Before treatment, immediately after the end of 10 sessions treatment (short-term) and 10 week later (long-term effect), pain intensity questionnaires (VAS) and quality of life in fibromyalgia patients questionnaire was completed by the patient. Results: Pain intensity were significantly lower in the treatment group than the sham group 2 weeks and 10 weeks after treatment than before treatment (P < 0.001). Although the quality of life of patients 2 weeks after treatment showed no significant change, but ten weeks after treatment were more than sham group (P < 0.0001). Conclusion: Our results suggest that tDCS is a safe and effective in treating fibromyalgia patients and an important effect in reducing pain and increasing quality of their life.

Keywords: fibromyalgia, tDCS, quality of life, VAS score

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395 Molecular Insights into the Genetic Integrity of Long-Term Micropropagated Clones Using Start Codon Targeted (SCoT) Markers: A Case Study with Ansellia africana, an Endangered, Medicinal Orchid

Authors: Paromik Bhattacharyya, Vijay Kumar, Johannes Van Staden

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Micropropagation is an important tool for the conservation of threatened and commercially important plant species of which orchids deserve special attention. Ansellia africana is one such medicinally important orchid species having much commercial significance. Thus, development of regeneration protocols for producing clonally stable regenerates using axillary buds is of much importance. However, for large-scale micropropagation to become not only successful but also acceptable by end-users, somaclonal variations occurring in the plantlets need to be eliminated. In the light of the various factors (genotype, ploidy level, in vitro culture age, explant and culture type, etc.) that may account for the somaclonal variations of divergent genetic changes at the cellular and molecular levels, genetic analysis of micropropagated plants using a multidisciplinary approach is of utmost importance. In the present study, the clonal integrity of the long term micropropagated A. africana plants were assessed using advanced molecular marker system i.e. Start Codon Targeted Polymorphism (SCoT). Our studies recorded a clonally stable regeneration protocol for A. africana with a very high degree of clonal fidelity amongst the regenerates. The results obtained from these molecular analyses could help in modifying the regeneration protocols for obtaining clonally stable true to type plantlets for sustainable commercial use.

Keywords: medicinal orchid micropropagation, start codon targeted polymorphism (SCoT), RAP), traditional African pharmacopoeia, genetic fidelity

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394 Advantages and Disadvantages of Socioscientific Issue Based Instruction in Science Classrooms: Pre-Service Science Teachers' Views

Authors: Aysegul Evren Yapicioglu

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The social roles and responsibilities expected from citizens are increasing due to changing global living conditions. Science education is expected to prepare conscious and sensitive students. Because today’s students are the adults of future. Precondition of this task is Teacher Education. In the past decade, one of the most important research field is socioscientific issues. This study deals with advantages and disadvantages of socioscientific issue based instruction in science classroom according to pre-service science teachers’ views. A case study approach that is one of the qualitative research design was used to explore their views. Fourteen pre-service science teachers participated to instruction process. Dolphinariums, Kyoto Protocol, genetically modified organisms, recyclable black bags’ benefits and damages, genetic tests, alternative energy sources and organ donation are examples of socioscientific issues, which were taught through activities in a special teaching course. Diaries and focus group interview were used as data collection tools. As a result of the study, the advantages of socioscientific issue based instruction in science classroom comprise of six sub-categories which are multi-skilling, social awareness development of thinking, meaningful learning, character and professional development, contribution of scientific literacy whereas disadvantages of this instruction process are challenges teachers and students, limitations of teaching and learning process in pre-service science teachers’ perspectives. Finally, this study contributes to science teachers and researchers to overcome disadvantages and benefit from the advantage of socioscientific issue based instruction in science classroom.

Keywords: science education, socioscientific issues, socioscientific issue based instruction, pre-service science teacher

Procedia PDF Downloads 180
393 Comparison of Efficacy between Low-Residue Diet and Clear-Liquid Diet in Colonoscopic Bowel Preparation at a Surgical Clinic: A Randomized Controlled Trial

Authors: Sopana Wongtawee

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Purpose: Adequate bowel cleansing is essential for a high quality, effective and safe colonoscopy. The aims of this study were to compare the efficacy of bowel preparation based on a low-residue diet before 8:00 followed by a clear-liquid diet, and a low-residue diet until 16:00 one day before colonoscopy using sodium phosphate solution (Xubil ®), the side effects of the two protocols and the patient satisfaction with them. Method: This was an endoscopist-blinded, prospective, randomized, controlled trial. A total of 224 patients (112 in each group) scheduled for outpatient colonoscopy met the criteria.They were randomized to either a low-residue diet consisting of white rice porridge with either fish, chicken or eggs before 8:00 followed by a clear-liquid diet (Group 1) or a low-residue diet consisting of the same food and drink, until 16:00 the day before colonoscopy(Group 2). All of them received 45 ml of sodium phosphate solution (Xubil ®) and three glasses of water (300 ml/glass) the evening before and the morning of the procedure. The cleansing efficacy of bowel preparation was rated according to the modified Rajawithi hospital bowel preparation score scale, patient satisfaction with bowel preparation was rated using Likert scale, and side effects of the 2 protocols was assessed using a patient questionnaire. Results: The cleansing efficacy between the two groups was significantly different (p=0.02). Satisfaction with bowel preparation and side effects were not different, except for the feeling of hunger in the first group (p=0.001). Conclusion: The low-residue diet consisting of white rice porridge with fish, chicken or eggs until 16:00 one day before colonoscopy achieved a better bowel-cleansing efficacy than the protocol consisting of clear liquid all day and rice porridge only before 8:00 one day before colonoscopy.

Keywords: bowel preparation, colonoscopy, sodium phosphate solution, nursing management

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392 Evaluating the Implementation of a Quality Management System in the COVID-19 Diagnostic Laboratory of a Tertiary Care Hospital in Delhi

Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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391 Oestrous Synchronization: A Technical Note for Nepalese Goat Farmers

Authors: Pravin Mishra, Ajeet K. Jha, Pankaj K. Jha

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This technical note is aimed at providing a brief information on goat breeds, its breeding seasonality and different methods of oestrous synchronization for Nepalese goat farmers. It was observed that, these goats are seasonal breeder and showed oestrous during mainly two season; December- February and March-May. This leads to an irregular supply of goat to market and a wide variations in market price. Oestrus synchronization is only an alternative reproductive tool to overcome this scarcity by enhancing production and productivity. This technique enables goat producers breed their animals within a short pre-determined period and permits breeding round the year. The principle of oestrus synchronisation is based on controlling of the luteal phase of the oestrous cycle. There are two basic mechanisms; one by shortening the luteal life (premature luteolysis) using prostaglandins or its analogues and the other by prolonging the luteal life (simulating the activity of natural progesterone produced by the corpus luteum) using exogenous progesterone source. The former is easy to apply and only effective during breeding season, whereas the latter is advantageous when the reproductive status of the goat flock is unknown. The common hormonal products easily available in Nepal includes; prostaglandins or its analogues (Oviprost® Dinoprost® Lutalyse® and Estrumate®), exogenous progesterone (Fluorogestone acetate® and Controlled Internal Drug Release®, CIDR) devices). However, before practicing the oestrous synchronization protocol, it needs to be validated for oestrous response rate, time to onset of oestrous, duration of oestrous and pregnancy rates at farmer’s field. In conclusion, application of oestrus synchronisation practice enhanced goat production and surplus the goat meat demand in Nepal.

Keywords: goat, Nepal, oestrous, synchronization

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390 Bionaut™: A Microrobotic Drug-Device Platform for the Local Treatment of Brainstem Gliomas

Authors: Alex Kiselyov, Suehyun Cho, Darrell Harrington; Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Michael Shpigelmacher

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Despite the most aggressive surgical and adjuvant therapeutic strategies, treatment of both pediatric and adult brainstem tumors remains problematic. Novel strategies, including targeted biologics, immunotherapy, and specialized delivery systems such as convection-enhanced delivery (CED), have been proposed. While some of these novel treatments are entering phase I trials, the field is still in need of treatment(s) that exhibits dramatically enhanced potency with optimal therapeutic ratio. Bionaut Labs has developed a modular microrobotic platform for performing localized delivery of diverse therapeutics in vivo. Our biocompatible particles (Bionauts™) are externally propelled and visualized in real-time. Bionauts™ are specifically designed to enhance the effect of radiation therapy via anatomically precise delivery of a radiosensitizing agent, as exemplified by temozolomide (TMZ) and Avastin™ to the brainstem gliomas of diverse origin. The treatment protocol is designed to furnish a better therapeutic outcome due to the localized (vs systemic) delivery of the drug to the neoplastic lesion(s) for use as a synergistic combination of radiation and radiosensitizing agent. In addition, the procedure is minimally invasive and is expected to be appropriate for both adult and pediatric patients. Current progress, including platform optimization, selection of the lead radiosensitizer as well as in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of porcine and ovine models, will be discussed.

Keywords: Bionaut, brainstem, glioma, local delivery, micro-robot, radiosensitizer

Procedia PDF Downloads 195
389 Effect of In-Season Linear Sprint Training on Sprint Kinematics of Amateur Soccer Players

Authors: Avinash Kharel

Abstract:

Background: - Linear sprint training is one possible approach to developing sprint performance, a crucial skill to focus on in soccer. Numerous methods, including various on-field training options, can be employed to attain this goal. However, the effect of In-season linear sprint training on sprint performance and related kinetics changes are unknown in a professional setting. The study aimed to investigate the effect of in-season linear sprint training on the sprint kinematics of amateur soccer players. Methods: - After familiarization, a 4-week training protocol was completed with sprint performance and Force Velocity (FV) profiles was compared before and after the training. Eighteen amateur soccer male players (Age 22 ± 2 years: Height: 178 ± 7cm; body-mass: 74 ± 8 Kg, 30-m split-time: 4.398 ± s) participated in the study. Sprint kinematics variables, including maximum Sprint Velocity (V0), Theoretical Maximum Force (F0), Maximum Force Output per kilogram of body weight (N/KG), Maximum Velocity (V(0)), Maximum Power Output (P MAX (W)), Ratio of Force to Velocity (FV), and Ratio of Force to Velocity at Peak power were measured. Results: - Results showed significant improvements in Maximum Sprint Velocity (p<0.01, ES=0.89), Theoretical Maximum Force (p<0.05, ES=0.50), Maximum Force Output per kilogram of body weight (p<0.05, ES=0.42), Maximum Power Output (p<0.05, ES=0.52), and Ratio of Force to Velocity at Peak Power (RF PEAK) (p<0.05, ES=0.44) post-training. There were no significant changes in the ratio of Force to Velocity (FV) and Maximum Velocity V (0) post-training (p>0.05). Conclusion: - These findings suggest that In-season linear sprint training can effectively improve certain sprint kinematics variables in amateur soccer players. Coaches and players should consider incorporating linear sprint training into their in-season training programs to improve sprint performance.

Keywords: sprint performance, training intervention, soccer, kinematics

Procedia PDF Downloads 73
388 Splinting in Plastic Surgery Hand Trauma Setting

Authors: Samar Mousa, Rebecca Shirley

Abstract:

Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

Procedia PDF Downloads 85
387 Accuracy of Trauma on Scene Triage Screen Tool (Shock Index, Reverse Shock Index Glasgow Coma Scale, and National Early Warning Score) to Predict the Severity of Emergency Department Triage

Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

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Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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386 Characterization and Pcr Detection of Selected Strains of Psychrotrophic Bacteria Isolated From Raw Milk

Authors: Kidane workelul, Li xu, Xiaoyang Pang, Jiaping Lv

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Dairy products are exceptionally ideal media for the growth of microorganisms because of their high nutritional content. There are several ways that milk might get contaminated throughout the milking process, including how the raw milk is transported and stored, as well as how long it is kept before being processed. Psychrotrophic bacteria are among the one which can deteriorate the quality of milk mainly their heat resistance proteas and lipase enzyme. For this research purpose 8 selected strains of Psychrotrophic bacteria (Entrococcus hirae, Pseudomonas fluorescens, Pseudomonas azotoformans, Pseudomonas putida, Exiguobacterium indicum, Pseudomonas paralactice, Acinetobacter indicum, Serratia liquefacients)are chosen and try to determine their characteristics based on the research methodology protocol. Thus, the 8 selected strains are cultured, plated incubate, extracted their genomic DNA and genome DNA was amplified, the purpose of the study was to identify their Psychrotrophic properties, lipase hydrolysis positive test, their optimal incubation temperature, designed primer using the noble strain P,flourescens conserved region area in target with lipA gene, optimized primer specificity as well as sensitivity and PCR detection for lipase positive strains using the design primers. Based on the findings both the selected 8 strains isolated from stored raw milk are Psychrotrophic bacteria, 6 of the selected strains except the 2 strains are positive for lipase hydrolysis, their optimal temperature is 20 to 30 OC, the designed primer specificity is very accurate and amplifies for those strains only with lipase positive but could not amplify for the others. Thus, the result is promising and could help in detecting the Psychrotrophic bacteria producing heat resistance enzymes (lipase) at early stage before the milk is processed and this will safe production loss for the dairy industry.

Keywords: dairy industry, heat-resistant, lipA, milk, primer and psychrotrophic

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385 Treatment of Porphyromonas gingivalis Induced Gingivitis in Albino Rats with Tetracycline-Loaded Nanochitosan, an Immunohistochemical Analysis

Authors: Rania Hanafi Said, Rasha Mohamed Taha

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Background: By using nanoparticles as drug delivery, it may be possible to avoid the drawbacks of systemic antibiotic dosing, including bacterial antibiotic resistance. The goal of this study was to see how well tetracycline loaded on nanochitosan worked to treat gingival inflammation in albino rats caused by Porphyromonas gingivalis. The study analyzed immunohistochemically the localization of the pro-inflammatory cytokine Interleukin-1beta (IL-1β). Material and methods: In this study, fifty mature male albino rats weighing 150 to 180 grams each were used. They were randomly divided into five groups. We checked for weight changes in rats. Ten male albino rats were included in Group I, which served as a negative control group. Ten rats were included in Group II, where they were exposed once to Porphyromonas. Group III contained ten rats, which were treated the same as Group II plus daily injections of diluted tetracycline powder at the infection sites. Ten rats in Group IV received the same procedure as those in Group II before receiving daily injections of nanochitosan at the injection sites. Finally, Group V, which had ten rats. Following the same protocol as Group II, they received localized injections of tetracycline loaded on nanochitosan once daily. Rats' gingivae were extracted and prepared after they were anesthetized. The biopsies were examined histologically and immunohistochemically by light microscopy. Results: Groups I and V had a nearly normal histological appearance of gingival tissue. In Groups II, III, and IV, degeneration was seen because the epithelial cells were bigger, collagen fibers were pulling away from the lamina propria connective tissue, and the basement membranes had come to an end. There was no discernible difference between groups V and I when they were examined immunohistochemically. Conclusion: The use of nano chitosan as a tetracycline carrier is a novel technique to overcome the drug's rising level of resistance.

Keywords: Immunohistochemistry, Nanochitosan, porphyromonas gingivitis, Tetracycline

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384 A Two Arm Double Parallel Randomized Controlled Trail of the Effects of Health Education Intervention on Insecticide Treated Nets Use and Its Practices among Pregnant Women Attending Antenatal Clinic: Study Protocol

Authors: Opara Monica, Suriani Ismail, Ahmad Iqmer Nashriq Mohd Nazan

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The true magnitude of the mortality and morbidity attributable to malaria worldwide is, at best, a scientific guess, although it is not disputable that the greatest burden is in sub-Saharan Africa. Those at highest risk are children younger than 5 years and pregnant women, particularly primigravidae. Nationally, malaria remains the third leading cause of death and is still considered a major public health problem. Therefore, this study is aimed to assess the effectiveness of health education intervention on insecticide-treated net use and its practices among pregnant women attending antenatal clinics. Materials and Methods: This study will be an intervention study with two arms double parallel randomized controlled trial (blinded) to be conducted in 3 stages. The first stage will develop health belief model (HBM) program, while in the second stage, pregnant women will be recruited, assessed (baseline data), randomized into two arms of the study, and follow-up for six months. The third stage will evaluate the impact of the intervention on HBM and disseminate the findings. Data will be collected with the use of a structured questionnaire which will contain validated tools. The main outcome measurement will be the treatment effect using HBM, while data will be analysed using SPSS, version 22. Discussion: The study will contribute to the existing knowledge on hospital-based care programs for pregnant women in developing countries where the literature is scanty. It will generally give insight into the importance of HBM measurement in interventional studies on malaria and other related infectious diseases in this setting.

Keywords: malaria, health education, insecticide-treated nets, sub-Saharan Africa

Procedia PDF Downloads 122
383 Cas9-Assisted Direct Cloning and Refactoring of a Silent Biosynthetic Gene Cluster

Authors: Peng Hou

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Natural products produced from marine bacteria serve as an immense reservoir for anti-infective drugs and therapeutic agents. Nowadays, heterologous expression of gene clusters of interests has been widely adopted as an effective strategy for natural product discovery. Briefly, the heterologous expression flowchart would be: biosynthetic gene cluster identification, pathway construction and expression, and product detection. However, gene cluster capture using traditional Transformation-associated recombination (TAR) protocol is low-efficient (0.5% positive colony rate). To make things worse, most of these putative new natural products are only predicted by bioinformatics analysis such as antiSMASH, and their corresponding natural products biosynthetic pathways are either not expressed or expressed at very low levels under laboratory conditions. Those setbacks have inspired us to focus on seeking new technologies to efficiently edit and refractor of biosynthetic gene clusters. Recently, two cutting-edge techniques have attracted our attention - the CRISPR-Cas9 and Gibson Assembly. By now, we have tried to pretreat Brevibacillus laterosporus strain genomic DNA with CRISPR-Cas9 nucleases that specifically generated breaks near the gene cluster of interest. This trial resulted in an increase in the efficiency of gene cluster capture (9%). Moreover, using Gibson Assembly by adding/deleting certain operon and tailoring enzymes regardless of end compatibility, the silent construct (~80kb) has been successfully refactored into an active one, yielded a series of analogs expected. With the appearances of the novel molecular tools, we are confident to believe that development of a high throughput mature pipeline for DNA assembly, transformation, product isolation and identification would no longer be a daydream for marine natural product discovery.

Keywords: biosynthesis, CRISPR-Cas9, DNA assembly, refactor, TAR cloning

Procedia PDF Downloads 282
382 Biomechanics of Ceramic on Ceramic vs. Ceramic on Xlpe Total Hip Arthroplasties During Gait

Authors: Athanasios Triantafyllou, Georgios Papagiannis, Vassilios Nikolaou, Panayiotis J. Papagelopoulos, George C. Babis

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In vitro measurements are widely used in order to predict THAs wear rate implementing gait kinematic and kinetic parameters. Clinical tests of materials and designs are crucial to prove the accuracy and validate such measurements. The purpose of this study is to examine the affection of THA gait kinematics and kinetics on wear during gait, the essential functional activity of humans, by comparing in vivo gait data to in vitro results. Our study hypothesis is that both implants will present the same hip joint kinematics and kinetics during gait. 127 unilateral primary cementless total hip arthroplasties were included in the research. Independent t-tests were used to identify a statistically significant difference in kinetic and kinematic data extracted from 3D gait analysis. No statistically significant differences observed at mean peak abduction, flexion and extension moments between the two groups (P.abduction= 0,125, P.flexion= 0,218, P.extension= 0,082). The kinematic measurements show no statistically significant differences too (Prom flexion-extension= 0,687, Prom abduction-adduction= 0,679). THA kinematics and kinetics during gait are important biomechanical parameters directly associated with implants wear. In vitro studies report less wear in CoC than CoXLPE when tested with the same gait cycle kinematic protocol. Our findings confirm that both implants behave identically in terms of kinematics in the clinical environment, thus strengthening in vitro results of CoC advantage. Correlated to all other significant factors that affect THA wear could address in a complete prism the wear on CoC and CoXLPE.

Keywords: total hip arthroplasty biomechanics, THA gait analysis, ceramic on ceramic kinematics, ceramic on XLPE kinetics, total hip replacement wear

Procedia PDF Downloads 154
381 Development of an Autonomous Automated Guided Vehicle with Robot Manipulator under Robot Operation System Architecture

Authors: Jinsiang Shaw, Sheng-Xiang Xu

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This paper presents the development of an autonomous automated guided vehicle (AGV) with a robot arm attached on top of it within the framework of robot operation system (ROS). ROS can provide libraries and tools, including hardware abstraction, device drivers, libraries, visualizers, message-passing, package management, etc. For this reason, this AGV can provide automatic navigation and parts transportation and pick-and-place task using robot arm for typical industrial production line use. More specifically, this AGV will be controlled by an on-board host computer running ROS software. Command signals for vehicle and robot arm control and measurement signals from various sensors are transferred to respective microcontrollers. Users can operate the AGV remotely through the TCP / IP protocol and perform SLAM (Simultaneous Localization and Mapping). An RGBD camera and LIDAR sensors are installed on the AGV, using these data to perceive the environment. For SLAM, Gmapping is used to construct the environment map by Rao-Blackwellized particle filter; and AMCL method (Adaptive Monte Carlo localization) is employed for mobile robot localization. In addition, current AGV position and orientation can be visualized by ROS toolkit. As for robot navigation and obstacle avoidance, A* for global path planning and dynamic window approach for local planning are implemented. The developed ROS AGV with a robot arm on it has been experimented in the university factory. A 2-D and 3-D map of the factory were successfully constructed by the SLAM method. Base on this map, robot navigation through the factory with and without dynamic obstacles are shown to perform well. Finally, pick-and-place of parts using robot arm and ensuing delivery in the factory by the mobile robot are also accomplished.

Keywords: automated guided vehicle, navigation, robot operation system, Simultaneous Localization and Mapping

Procedia PDF Downloads 149
380 A Methodological Approach to Development of Mental Script for Mental Practice of Micro Suturing

Authors: Vaikunthan Rajaratnam

Abstract:

Intro: Motor imagery (MI) and mental practice (MP) can be an alternative to acquire mastery of surgical skills. One component of using this technique is the use of a mental script. The aim of this study was to design and develop a mental script for basic micro suturing training for skill acquisition using a low-fidelity rubber glove model and to describe the detailed methodology for this process. Methods: This study was based on a design and development research framework. The mental script was developed with 5 expert surgeons performing a cognitive walkthrough of the repair of a vertical opening in a rubber glove model using 8/0 nylon. This was followed by a hierarchal task analysis. A draft script was created, and face and content validity assessed with a checking-back process. The final script was validated with the recruitment of 28 participants, assessed using the Mental Imagery Questionnaire (MIQ). Results: The creation of the mental script is detailed in the full text. After assessment by the expert panel, the mental script had good face and content validity. The average overall MIQ score was 5.2 ± 1.1, demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model. Conclusion: The methodological approach described in this study is based on an instructional design framework to teach surgical skills. This MP model is inexpensive and easily accessible, addressing the challenge of reduced opportunities to practice surgical skills. However, while motor skills are important, other non-technical expertise required by the surgeon is not addressed with this model. Thus, this model should act a surgical training augment, but not replace it.

Keywords: mental script, motor imagery, cognitive walkthrough, verbal protocol analysis, hierarchical task analysis

Procedia PDF Downloads 103
379 Prevalence of Malocclusion and Assessment of Orthodontic Treatment Needs in Malay Transfusion-Dependent Thalassemia Patients

Authors: Mohamed H. Kosba, Heba A. Ibrahim, H. Rozita

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Statement of the Problem: The life expectancy for transfusion-dependent thalassemia patients has increased dramatically with iron-chelation therapy and other modern management modalities. In these patients, the most dominant maxillofacial manifestations are protrusion of zygomatic bones and premaxilla due to the hyperplasia of bone marrow. The purpose of this study is to determine the prevalence of malocclusion and orthodontic treatment needs according to the Dental Aesthetic Index (DAI) among Malay transfusion-dependent thalassemia patients. Orientation: This is a cross-sectional study consist of 43 Malay transfusion-dependent thalassemia patients, 22 males, and 19 females with the mean age of 15.9 years old (SD 3.58). The subjects were selected randomly from patients attending Paediatrics and Internal Medicine Clinic at Hospital USM and Hospital Sultana Bahiyah. The subjects were assessed for malocclusion according to Angle’s classification, and orthodontic treatment needs using DAI. The results show that 22 of the subjects (51.1%) have class II malocclusion, 12 subjects (28%) have class І, while 9 subjects (20.9%) have class Ⅲ. The assessment of orthodontic treatment needs to reveal 22 cases (51.1%) fall in the normal/minor needs category, 12 subjects (28%) fall in the severe and very severe category, while 9 subjects (20.9%) fall in the definite category. Conclusion & Significance: Half of Malay transfusion-dependent thalassemia patients have Class Ⅱmalocclusion. About 28% had malocclusion and required orthodontic treatment. This research shows that Malay transfusion-dependent thalassemia may require orthodontic management; earlier intervention to reduce the complexity of the treatment later, suggesting functional appliance as a suitable treatment option for them, a twin block appliance together with headgear to restrict maxillary growth suggested for management. The current protocol implemented by the Malaysian Ministry of Health for the management of these patients seems to be sufficient since the result shows that about 28% require orthodontic treatment need, according to DAI.

Keywords: prevalence, DAI, thalassaemia, angle classification

Procedia PDF Downloads 143