Search results for: poor outcome of delayed breast cancer treatment

Authors: Shubhangi Roy

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Relational Contracts (informal understandings not enforceable by law) are a common feature of most economies. However, their dominance is higher in developing countries. Such informality of economic sectors is often co-related to lower economic growth. The aim of this paper is to investigate whether informal arrangements i.e. relational contracts are a cause or symptom of lower levels of economic and/or institutional development. The methodology followed involves an initial survey of 150 test subjects in Northern India. The subjects are all members of occupations where they frequently transact ensuring uniformity in transaction volume. However, the subjects are from varied socio-economic backgrounds to ensure sufficient variance in transaction values allowing us to understand the relationship between the amount of money involved to the method of transaction used, if any. Questions asked are quantitative and qualitative with an aim to observe both the behavior and motivation behind such behavior. An overarching similarity observed during the survey across all subjects’ responses is that in an economy like India with pervasive corruption and delayed litigation, economy participants have created alternative social sanctions to deal with non-performers. In a society that functions predominantly on caste, class and gender classifications, these sanctions could, in fact, be more cumbersome for a potential rule-breaker than the legal ramifications. It, therefore, is a symptom of weak formal regulatory enforcement and dispute settlement mechanism. Additionally, the study bifurcates such informal arrangements into two separate systems - a) when it exists in addition to and augments a legal framework creating an efficient socio-legal equilibrium or; b) in conflict with the legal system in place. This categorization is an important step in regulating informal arrangements. Instead of considering the entire gamut of such arrangements as counter-development, it helps decision-makers understand when to dismantle (latter) and when to pivot around existing informal systems (former). The paper hypothesizes that those social arrangements that support the formal legal frameworks allow for cheaper enforcement of regulations with lower enforcement costs burden on the state mechanism. On the other hand, norms which contradict legal rules will undermine the formal framework. Law infringement, in presence of these norms, will have no impact on the reputation of the business or individual outside of the punishment imposed under the law. It is especially exacerbated in the Indian legal system where enforcement of penalties for non-performance of contracts is low. In such a situation, the social norm will be adhered to more strictly by the individuals rather than the legal norms. This greatly undermines the role of regulations. The paper concludes with recommendations that allow policy-makers and legal systems to encourage the former category of informal arrangements while discouraging norms that undermine legitimate policy objectives. Through this investigation, we will be able to expand our understanding of tools of market development beyond regulations. This will allow academics and policymakers to harness social norms for less disruptive and more lasting growth.

Keywords: distribution of income, emerging economies, relational contracts, sample survey, social norms

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Authors: Lilian A. Okeke, I. Okeke, N. Waziri, S. Balogun, P. Nguku, O. Fawole

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Background: Access to ante-natal care services promotes safe motherhood and delivery with improved maternal and neonatal outcome. We conducted this study to identify factors influencing the utilization of antenatal care (ANC) and health delivery services. Methods: We conducted a cross sectional study. Households were numbered and a one in three sample was selected using a systematic sampling method. One hundred and ninety eight women who were either pregnant or had previous deliveries were interviewed using pretested structured questionnaires to obtain information on their socio-demographic characteristics, and reasons for non-utilization of ANC and health delivery services. We performed univariate and bivariate analysis using Epi info version 3.5.3. Results: The age of respondents ranged from (17-55 years) with a median age of 29 years. One hundred and ninety two (97%) utilized antenatal care services. Ninety three (47.9%) attended ANC at second trimester. More than half (58.6%) had ≥ 4 visits to ANC. One hundred and thirty one (66.2%) had their last delivery at home by a traditional birth attendant. Factors associated with ANC and health facility delivery services utilization were: age group 45-55 (OR 0.01; 95% CI: 0.00-0.16) and > 55 years (OR 0.03; 95% CI: 0.00-0.60), wife’s educational status (OR 3.17; 95% CI: 1.66-8.30), husband’s permission (OR 11.8; 95% CI 2.19-63.62), and distance ≥ 5km (OR 0.33; 95% CI: 0.16-0.60). Conclusion: ANC services were well utilized. Most women did not book early and had their last delivery at home. Predictors of ANC use and health facility delivery were age, wife’s educational status, husband's permission and long distance from health facility. A one-day health sensitization of the benefits of ANC utilization and the dangers of delivering at home was implemented.

Keywords: ante natal care, health facility, delivery services, rural area, Plateau state

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Authors: Uzoamaka Nwugo Akwiwu

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Human Immunodeficiency Virus (HIV) among rural dwellers depletes quality of agricultural labour, and reduces quality of life. Use of Antiretroviral Therapy (ART) has not significantly reduced consequences of infection, as the effort is being compromised by inadequate dietary intake. This study analysed the dietary intake of People Living with HIV/AIDS (PLWHA) in rural communities of Imo State, Nigeria. Data was collected from 114 PLWHA randomly selected from members of two rural support groups with high prevalence of HIV in Imo State using interview schedule. The data was analysed using descriptive statistics, Pearson product moment correlation, and t-test at α0.05. Level of involvement in agriculture was (mean 12.7) and reduced to 7.0 after infection. Extent of involvement in agriculture significantly reduced after infection in Imo (t=8.1). Health status of 42.1% of PLWHA was perceived as poor. Diet diversity score (4.3±1.6) was low among majority (62.3%) of the PLWHA, with diet of 76.3% being inadequate. However, perceived health status had no significant correlation with dietary intake (r=0.09). The study concluded that diet of PLWHA in Imo State was inadequate, thus there is need for agricultural extension agents to collaborate with the health sector to develop nutritional guideline for PLWHA in rural communities.

Keywords: dietary intake, diet diversity, people living With HIV/AIDS, perceived health status

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Authors: Shaimaa Eltanani, Thangal Yumnamcha, Ahmed S. Ibrahim

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Purpose: Mitochondria dysfunction is central to breaking the barrier integrity of retinal endothelial cells (RECs) in various blinding eye diseases such as diabetic retinopathy and retinopathy of prematurity. Therefore, we aimed to dissect the role of different mitochondrial components, specifically, those of oxidative phosphorylation (OxPhos), in maintaining the barrier function of RECs. Methods: Electric cell-substrate impedance sensing (ECIS) technology was used to assess in real-time the role of different mitochondrial components in the total impedance (Z) of human RECs (HRECs) and its components; the capacitance (C) and the total resistance (R). HRECs were treated with specific mitochondrial inhibitors that target different steps in OxPhos: Rotenone for complex I; Oligomycin for ATP synthase; and FCCP for uncoupling OxPhos. Furthermore, data were modeled to investigate the effects of these inhibitors on the three parameters that govern the total resistance of cells: cell-cell interactions (Rb), cell-matrix interactions (α), and cell membrane permeability (Cm). Results: Rotenone (1 µM) produced the greatest reduction in the Z, followed by FCCP (1 µM), whereas no reduction in the Z was observed after the treatment with Oligomycin (1 µM). Following this further, we deconvoluted the effect of these inhibitors on Rb, α, and Cm. Firstly, rotenone (1 µM) completely abolished the resistance contribution of Rb, as the Rb became zero immediately after the treatment. Secondly, FCCP (1 µM) eliminated the resistance contribution of Rb only after 2.5 hours and increased Cm without considerable effect on α. Lastly, Oligomycin had the lowest impact among these inhibitors on Rb, which became similar to the control group at the end of the experiment without noticeable effects on Cm or α. Conclusion: These results demonstrate differential roles for complex I, complex V, and coupling of OxPhos in maintaining the barrier functionality of HRECs, in which complex I being the most important component in regulating the barrier functionality and the spreading behavior of HRECs. Such differences can be used in investigating gene expression as well as for screening selective agents that improve the functionality of complex I to be used in the therapeutic approach for treating REC-related retinal diseases.

Keywords: human retinal endothelial cells (hrecs), rotenone, oligomycin, fccp, oxidative phosphorylation, oxphos, capacitance, impedance, ecis modeling, rb resistance, α resistance, and barrier integrity

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Authors: Viktor Kochkodan

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The main problem arising upon water treatment and desalination using pressure driven membrane processes such as microfiltration, ultrafiltration, nanofiltration and reverse osmosis is membrane fouling that seriously hampers the application of the membrane technologies. One of the main approaches to mitigate membrane fouling is to minimize adhesion interactions between a foulant and a membrane and the surface coating of the membranes with polyelectrolytes seems to be a simple and flexible technique to improve the membrane fouling resistance. In this study composite polyamide membranes NF-90, NF-270, and BW-30 were modified using electrostatic deposition of polyelectrolyte multilayers made from various polycationic and polyanionic polymers of different molecular weights. Different anionic polyelectrolytes such as: poly(sodium 4-styrene sulfonate), poly(vinyl sulfonic acid, sodium salt), poly(4-styrene sulfonic acid-co-maleic acid) sodium salt, poly(acrylic acid) sodium salt (PA) and cationic polyelectrolytes such as poly(diallyldimethylammonium chloride), poly(ethylenimine) and poly(hexamethylene biguanide were used for membrane modification. An effect of deposition time and a number of polyelectrolyte layers on the membrane modification has been evaluated. It was found that degree of membrane modification depends on chemical nature and molecular weight of polyelectrolytes used. The surface morphology of the prepared composite membranes was studied using atomic force microscopy. It was shown that the surface membrane roughness decreases significantly as a number of the polyelectrolyte layers on the membrane surface increases. This smoothening of the membrane surface might contribute to the reduction of membrane fouling as lower roughness most often associated with a decrease in surface fouling. Zeta potentials and water contact angles on the membrane surface before and after modification have also been evaluated to provide addition information regarding membrane fouling issues. It was shown that the surface charge of the membranes modified with polyelectrolytes could be switched between positive and negative after coating with a cationic or an anionic polyelectrolyte. On the other hand, the water contact angle was strongly affected when the outermost polyelectrolyte layer was changed. Finally, a distinct difference in the performance of the noncoated membranes and the polyelectrolyte modified membranes was found during treatment of seawater in the non-continuous regime. A possible mechanism of the higher fouling resistance of the modified membranes has been discussed.

Keywords: contact angle, membrane fouling, polyelectrolytes, surface modification

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Authors: Min-Pei Ling

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Aflatoxin is a fungal secondary metabolite with high toxicity capable of contaminating various types of food crops. It has been identified as a Group 1 human carcinogen by the International Agency for Research on Cancer. Chronic aflatoxin exposure has caused a worldwide public food safety concern. Peanuts and peanut products are the major sources of aflatoxin exposure. Therefore, some reduction interventions have been developed to minimize contamination through the peanut production chain. The purpose of this study is to estimate the efficacy of interventions in reducing the health impact of hepatocellular carcinoma caused by aflatoxin contamination in peanuts. The estimated total disability-adjusted life-years (DALYs) was calculated using FDA-iRISK online software. Six aflatoxin reduction strategies were evaluated, including good agricultural practice (GAP), biocontrol, Purdue Improved Crop Storage packaging, basic processing, ozonolysis, and ultraviolet irradiation. The results indicated that basic processing could prevent huge public health loss of 4,079.7–21,833 total DALYs per year, which accounted for 39.6% of all decreased total DALYs. GAP and biocontrol were both effective strategies in the farm field, while the other three interventions were limited in reducing total DALYs. In conclusion, this study could help farmers, processing plants, and government policymakers to alleviate aflatoxin contamination issues in the peanut production chain.

Keywords: aflatoxin, health burden, disability-adjusted life-years, peanuts

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Authors: Piyush Bajpai, Sneha Pandey

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Mumbai’s Dhobighat, 150 year old largest open laundry in the world, is the true live-work place and only source of income for some of Mumbai’s highest density ‘urban poor’ residents. The regeneration of Dhobighat, due to its ultra prime location and complex socio-political culture has been a complex issue. This once flourishing urban industrial core has been degrading for the past several decades mainly due to the decline of the open laundry business, the site’s over burdened infrastructure and conflicting socio-political and economic forces. The phenomena of ‘exaptation’ or ‘co-option’ has been observed by evolutionary biologists as a process responsible for producing highly tenacious and resilient offsprings within a species. The reddish egret uses its wings to cast shadow in shallow waters to attract small fish and hunt them. An unrelated feature used opportunistically to produce a very favorable result. How can this idea of co-option be applied to resolve the complex issue of Dhobighat’s regeneration? Our paper proposes a new methodology/approach for the regeneration of Dhobighat through the lens of evolutionary biology. Forces and systems (social, political, economic, cultural and ecological) that seem conflicting or unrelated by nature are opportunistically transformed into symbiotic and complimentary relationships that produce an inclusive, resilient and holistic solution for the regeneration of Dhobighat.

Keywords: urban regeneration, exaptation, resilience, Dhobighat, Mumbai

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Authors: P. Joris, E. Lombard, X. Cameleyre, G. Navarro, A. Paillet, N. Gorret, S. E. Guillouet

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Today, on the international space station, multiple supplies are needed per year to supply food and spare parts and to take out waste. But as it is planned to go longer and further into space these supplies will no longer be possible. The astronaut life support system must be able of continuously transform waste into valuable compounds. Two types of production were identified as critical and could be be supplemented by microorganisms. On the one hand, since microgravity causes rapid muscle loss, single cell proteins (SCPs) could be used as protein rich feed or food. On the other hand, having enough building materials to build an advanced habitat will not be possible only by transporting space goods from earth to mars for example. The bacterium Cupriavidus. necator is well known for its ability to produce a large amount of proteins or of polyhydroxyalkanoate biopolymers (PHAs) depending on its implementation. By coupling the life support system to a 3D-printer, astronauts could be supplied with an unlimited amount of building materials. Additionally, based on the design of the life support system, waste streams have been identified: urea from the crew urine and volatile fatty acids (VFAs) from a first stage of organic waste (excrement and food waste) treatment through anaerobic digestion. Thus, the objective of this, within the Spaceship.Fr project, was to demonstrate the feasibility of producing SCPs and PHAs from VFAs and urea in bioreactor. Because life support systems operate continuously as loops, continuous culture experiments were chosen and the effect of the bioreactor dilution rate on biomass composition was investigated. Total transformation of the carbon source into biomass with high SCP or PHA content was achieved in all cases. We will present the transformation performances of VFAs and urea by the bacteria in bioreactor in terms of titers, yields and productivities but also in terms of the quality of SCP and PHA produced, nucleic acid content. We will further discuss the envisioned integration of our process within life support systems.

Keywords: life support system, space travel, waste treatment, single cell proteins, polyhydroxyalkanoates, bioreactor

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Authors: O. Onigbogi, M. Onigbogi Jr., O. Ojo

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Background: The advances in mobile telephone technology has led to a rise in its use globally which has improved service delivery, empowered businesses and changed the way people access information. The practice of many health professionals has also been affected by the information and communications technology (ICT) revolution because they have better access to information. This study was conducted to assess the willingness to participate in mobile technology interventions to improve pregnancy outcomes in Lagos, Nigeria. Materials and Methods: A total of 238 respondents completed self-administered questionnaires. SPSS version 18 data editor was used to analyze data. Univariate odds ratios and 95% confidence intervals (95 % CI) were used to evaluate the correlates of Willingness to Use (WTU) mobile phones to receive health messages during pregnancy. Results: A total of 107 women (45% of the respondents) reported that they will be willing to receive health-related information on their phones during pregnancy. Greater willingness was associated with higher education (OR = 1.25, 95% CI: 1.13–1.53), involvement with community volunteer organizations (OR = 1.25, 95% CI: 1.05–1.52), monetary incentives (OR = 1.37, 95% CI: 1.14–1.45) and nulliparity (OR = 1.39, 95% CI: 1.02–1.42). Decreased willingness was associated with concerns about wrong interpretation of information (OR = 0.42, 95% CI: 0.21–0.54), poor mobile telephone service by providers (OR = 0.61, 95% CI: 0.52–0.78), increase in number of messages (OR = 0.78, 95% CI: 0.53–0.76). Conclusion: The level of WTU recorded indicates that much work still needs to be done before this novel approach could be used adopted in delivering health-related information. Incentives for would-be subjects should also be a part of the planning to encourage greater participation.

Keywords: mobile, outcomes, pregnancy, technology, telephone

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Authors: Mathew Nyashanu, George K. Kiggundu, Mandu S. Ekpenyong

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There is an increased number of young people engaging in early sexual relationships worldwide. Furthermore, statistics for early pregnancy among young people have also increased, especially in low and middle-income countries. This has health implications for both the parents and the baby. High uptake in family planning contraception among young people can reduce early pregnancy and subsequent negative health outcomes on the young parents and the baby. This study was set to explore the factors influencing the uptake of family planning contraceptive services among young people (18-24 years) at a community level in rural Budaka district, Uganda. The study utilised an explorative qualitative approach. The study found out that religion, partner resistance; perceived loss of libido, perceived barren, long waiting time and distance from the health facility, lack of privacy/confidentiality, excessive menstrual bleeding, cancer, and fear of having disabled babies, limited the utilisation of family planning contraceptive services while contraception as HIV prevention and child spacing encouraged young people to use family planning contraceptive services. There is a need for a culturally orientated community-based contraceptive health promotion approach to increase the uptake of family planning contraception services among young people.

Keywords: Young people, Family Planning, Contraceptives, Black sub-Sahara African

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Authors: Akpokiere Ugbede Roseline

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Chemistry is an activity oriented subject in which many students achievement over the years are not encouraging. Among the reasons found to be responsible for student’s poor performance in chemistry are ineffective teaching strategies. This study, therefore, sought to determine the effect of guided inquiry, guided inquiry with demonstration, and demonstration with conventional approach on pre-service teachers’ cognitive attainment and practical skills acquisition on stoichiometry and chemical reactions in practical chemistry, Two research questions and hypotheses were each answered and tested respectively. The study was a quasi-experimental research involving 50 students in each of the experimental groups and 50 students in the control group. Out of the five instruments used for the study, three were on stimulus and two on response (Test of Cognitive Attainment and Test of Practical Skills in Chemistry) instruments administered, and dataobtained were analyzed with t-test and Analysis of Variance. Findings revealed, among others, that there was a significant effect of treatments on students' cognitive attainment and on practical skills acquisition. Students exposed to guided inquiry (with/without demonstration) strategies achieved better than those exposed to demonstration with conventional strategy. It is therefore recommended, among others, that Lecturers in Colleges of Education should utilize the guided inquiry strategy for teaching concepts in chemistry.

Keywords: instructional strategy, practical chemistry, learning outcomes, pre-service teachers

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Authors: Juan Sebastián Rivera Soriano, Rosa Urbano Gutiérrez

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The Shodan House and the Sarabhai House (Ahmedabad, India, 1954 and 1955, respectively) are considered some of the most important works of Le Corbusier produced in the last stage of his career. There are some academic publications that study the compositional and formal aspects of their architectural design, but there is no in-depth investigation into how the climatic conditions of this region were a determining factor in the design decisions implemented in these projects. This paper argues that Le Corbusier developed a specific architectural design strategy for these buildings based on scientific research on climate in the Indian context. This new language was informed by a pioneering study and interpretation of climatic data as a design methodology that would even involve the development of new design tools. This study investigated whether their use of climatic data meets values and levels of accuracy obtained with contemporary instruments and tools, such as Energy Plus weather data files and Climate Consultant. It also intended to find out if Le Corbusier's office’s intentions and decisions were indeed appropriate and efficient for those climate conditions by assessing these projects using BIM models and energy performance simulations from Design Builder. Accurate models were built using original historical data through archival research. The outcome is to provide a new understanding of the environment of these houses through the combination of modern building science and architectural history. The results confirm that in these houses, it was achieved a model of low energy consumption. This paper contributes new evidence not only on exemplary modern architecture concerned with environmental performance but also on how it developed progressive thinking in this direction.

Keywords: bioclimatic architecture, Le Corbusier, Shodan, Sarabhai Houses

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Authors: Rahul S. Raj

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Electro-mechanical impedance technique is a recently developed non-destructive method for structural health monitoring. This system comprises of piezo electric patch, bonded to the structure using an adhesive/epoxy and electrically excited to determine the health of the component. The subjected electric field actuates the PZT patch harmonically and imparts a force on the host structure. The structural response thus produced by the host component is in the form of peaks and valleys which further shows the admittance signatures of the structure for the given excitation frequency. Adhesives have the capability to change the structural signatures, in EMI technique, by transforming conductance and susceptance signatures. The static approximation provide a justifiable result where adhesive bond lines are thin and stiff. The epoxy adhesive bonds limits design flexibility due to poor bond strengths, hence to enhance the performance of the joints, a new technique is developed for joining PZT, i.e. the alloy bonding technique. It is a metallic joining compound which contains many active elements including Titanium, that reacts with the tenacious surface films of the ceramic and composites to create excellent bonds. This alloy-based bonding technique will be used for better strain interaction and rigorous stress transfer between PZT patch and the host structure.

Keywords: EMI technique, conductance, susceptance, admittance, alloy bonding

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Authors: Eny Syatriana

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English proficiency of Indonesian secondary school students is below standard. The low proficiency may come from poor teaching materials that do not meet the students’ need. The main objective for English teachers is to improve the English proficiency of the students. The purpose of this study is to explore the application Mapping, Practicing, Using (MPU) strategy with Instructional Materials Based on the School Curriculum toward the English achievement of Indonesian EFL Students. This paper is part my dissertation entitles 'Designing instructional materials for secondary school students based on the school curriculum' consisting of need analysis, design, development, implementation, and evaluation; this paper discusses need analysis and creates a model of creating instructional materials through deep discussion among teachers of secondary schools. The subject consisted of six English teachers and students of three classes at three different secondary schools in Makassar, South Sulawesi, Indonesia. Pretest and posttest design were administered to see the effectiveness of the MPU strategy. Questionnaires were administered to see the teachers and students’ perception toward the instructional materials. The result indicates that the MPU strategy is effective in improving the English achievement; instructional materials with different strategies improve the English achievement of the students. Both teachers and students argue that the presented instructional materials are effective to be used in the teaching and learning process to increase the English proficiency of the students.

Keywords: proficiency, development, English for secondary school students, instructional materials

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Authors: Zakia Belhadj, Bing He, Hua Zhang, Xueqing Wang, Wenbing Dai, Qiang Zhang

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Mononuclear phagocyte system (MPS) forms an abominable obstacle hampering the tumor delivery efficiency of nanoparticles. Passively targeted nanocarriers have received clinical approval over the past 20 years. However, none of the actively targeted nanocarriers have entered clinical trials. Thus it is important to endue effective targeting ability to actively targeted approaches by overcoming biological barriers to nanoparticle drug delivery. Here, it presents that an Esomeprazole-based preconditioning strategy for regulating nanocarrier-MPS interaction to substantially prolong circulation time and enhance tumor targeting of nanoparticles. In vitro, the clinically approved proton pump inhibitor Esomeprazole “ESO” was demonstrated to reduce interactions between macrophages and subsequently injected targeted vesicles by interfering with their lysosomal trafficking. Of note, in vivo studies demonstrated that ESO pretreatment greatly decreased the liver and spleen uptake of c(RGDm7)-modified vesicles, highly enhanced their tumor accumulation, thereby provided superior therapeutic efficacy of c(RGDm7)-modified vesicles co-loaded with Doxorubicin (DOX) and Gefitinib (GE). This MPS-preconditioning strategy using ESO provides deeper insights into regulating nanoparticles interaction with the phagocytic system and enhancing their cancer cells' accessibility for anticancer therapy.

Keywords: esomeprazole (ESO), mononuclear phagocyte system (MPS), preconditioning strategy, targeted lipid vesicles

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Authors: Hemang Madhusudan Anglay, Akash Gaur

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Value of visual perception in today’s context is vulnerable. Visual Graphic broadly and conveniently expresses culture, language and science of art that satisfactorily is a mould to cast various expressions. It is one of the essential parts of communication design which relatively can be used to approach the above areas of expressions. In between the receptors and interpreters, there is an expanse of comprehension and cliché in relation to the use of Visual Graphics. There are pedagogies, commodification and honest reflections where Visual Graphic is a common area of interest. The traditional receptors amidst the dilemma of this very situation find themselves in the pool of media, medium and interactions. Followed by a very vague interpretation the entire circle of communication becomes a question of comprehension vs cliché. Residing in the same ‘eco-system’ these communities who make pedagogies and multiply its reflections sometimes with honesty and sometimes on commercial values tend to function differently. With the advent of technology, which is a virtual space allows the user to access various forms of content. This diminishes the core characteristics and creates a vacuum even though it satisfies the user. The symbolic interpretation of visual form and structure is transmitted in a culture by the means of contemporary media. Starting from a very individualistic approach, today it is beyond Print & Electronic media. The expected outcome will be a study of Ahmedabad City, situated in the Gujarat State of India. It is identity with respect to socio-cultural as well as economic changes. The methodology will include process to understand the evolution and narratives behind it that will encompass diverse community, its reflection and it will sum up the salient features of communication through combination of visual and graphic that is relevant in Indian context trading its values to global scenario.

Keywords: communication, culture, graphic, visual

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Authors: Sujatha Edla

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Introduction: New compounds and possible uses for the bioactive substances produced by freshwater cyanobacteria are constantly being discovered through research. Certain molecules are hazardous to the environment and human health, but others have potential applications in industry, biotechnology, and pharmaceuticals. These discoveries advance our knowledge of the varied functions these microbes perform in different ecosystems. Cyanobacterial silver nanoparticles (AgNPs) have special qualities and possible therapeutic advantages, which make them very promising for a range of medicinal uses. Aim: In our study; the attention was focused on the analysis and characterization of bioactive compounds extracted from freshwater cyanobacteria Planktothricoides raciorskii and its comparative study on Cyanobacteria-mediated silver nanoparticles synthesized by cell-free extract of Planktothricoides raciorskii. Material and Methods: A variety of bioactive secondary metabolites have been extracted, purified, and identified from cyanobacterial species using column chromatography, FTIR, and GC-MS/MS chromatography techniques and evaluated for antibacterial and cytotoxic studies, where the Cyanobacterial silver nanoparticles (CSNPs) were characterized by UV-Vis spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM), and Fourier transform infrared (FTIR) analysis and were further tested for antibacterial and cytotoxic efficiency. Results: The synthesis of CSNPs was confirmed through visible color change and shift of peaks at 430–445 nm by UV-Vis spectroscopy. The size of CSNPs was between 22 and 34 nm and oval-shaped which were confirmed by SEM and TEM analyses. The FTIR spectra showed a new peak at the range of 3,400–3,460 cm−1 compared to the control, confirming the reduction of silver nitrate. The antibacterial activity of both crude bioactive compound extract and CSNPs showed remarkable activity with Zone of inhibition against E. coli with 9.5mm and 10.2mm, 13mm and 14.5mm against S. paratyphi, 9.2mm and 9.8mm zone of inhibition against K. pneumonia by both crude extract and CSNPs, respectively. The cytotoxicity as evaluated by extracts of Planktothricoides raciorskii against MCF7-Human Breast Adenocarcinoma cell line and HepG2- Human Hepatocellular Carcinoma cell line employing MTT assay gave IC50 value of 47.18ug/ml, 110.81ug/ml against MCF7cell line and HepG2 cell line, respectively. The cytotoxic evaluation of Planktothricoides raciorskii CSNPs against the MCF7cell line was 43.37 ug/ml and 20.88 ug/ml against the HepG2 cell line. Our ongoing research in this field aims to uncover the full therapeutic potential of cyanobacterial silver nanoparticles and address any associated challenges.

Keywords: cyanobacteria, silvernanoparticles, pharmaceuticals, bioactive compounds, cytotoxic

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Authors: Abduselam Faris, Rijalu Negash, Zera Kedir

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This study was initiated to identify constraints and opportunities of the wood production value chain in Southwest Ethiopia. About 385 wood trees growing farmers were randomly interviewed. Similarly, about 30 small-scale wood processors, 30 retailers, 15 local collectors and 5 wholesalers were purposively included in the study. The results of the study indicated that 98.96 % of the smallholder farmers that engaged in the production of wood trees which is used for wood were male-headed, with an average age of 46.88 years. The main activity that the household engaged was agriculture (crop and livestock) which accounts for about 61.56% of the sample respondents. Through value chain mapping of actors, the major value chain participant and supporting actors were identified. On average, the tree-growing farmers generated gross income of 9385.926 Ethiopian birr during the survey year. Among the critical constraints identified along the wood production value chain was limited supply of credit, poor market information dissemination, high interference of brokers, and shortage of machines, inadequate working area and electricity. The availability of forest resources is the leading opportunity in the wood production value chain. Reinforcing the linkage among wood production value chain actors, providing skill training for small-scale processors, and developing suitable policy for wood tree wise use is key recommendations forward.

Keywords: value chain analysis, wood production, southwest Ethiopia, constraints and opportunities

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Authors: Ilaria Lucrezia Amerise

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The statistical modelling of precipitation data for a given portion of territory is fundamental for the monitoring of climatic conditions and for Hydrogeological Management Plans (HMP). This modelling is rendered particularly complex by the changes taking place in the frequency and intensity of precipitation, presumably to be attributed to the global climate change. This paper applies the Wakeby distribution (with 5 parameters) as a theoretical reference model. The number and the quality of the parameters indicate that this distribution may be the appropriate choice for the interpolations of the hydrological variables and, moreover, the Wakeby is particularly suitable for describing phenomena producing heavy tails. The proposed estimation methods for determining the value of the Wakeby parameters are the same as those used for density functions with heavy tails. The commonly used procedure is the classic method of moments weighed with probabilities (probability weighted moments, PWM) although this has often shown difficulty of convergence, or rather, convergence to a configuration of inappropriate parameters. In this paper, we analyze the problem of the likelihood estimation of a random variable expressed through its quantile function. The method of maximum likelihood, in this case, is more demanding than in the situations of more usual estimation. The reasons for this lie, in the sampling and asymptotic properties of the estimators of maximum likelihood which improve the estimates obtained with indications of their variability and, therefore, their accuracy and reliability. These features are highly appreciated in contexts where poor decisions, attributable to an inefficient or incomplete information base, can cause serious damages.

Keywords: generalized extreme values, likelihood estimation, precipitation data, Wakeby distribution

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Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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Authors: Özge Çeliker Tosun, Melda Başer Secer, İsmail Düşmez, Sedat Çapar, İlkay Kozak, Melahat Aktaş, Furkan Can Şimşek, Gökhan Tosun

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Purpose: Portable innovative balance room system with digital game program; It was created to be able to be divided into small areas, such as inside the house, garden, balcony, to enable the person to enter and perform both evaluation and exercise safely, and to ensure that these results can be stored and sent to the therapist live or later when desired. The aim is to compare the effectiveness of the exercise program applied by the elderly within this system and the exercise program implemented under the supervision of a physiotherapist on balance and urinary incontinence symptoms. Materials and Methods: The study was conducted in a randomized controlled manner on 63 people with urinary incontinence (mean age: 75.5 years) at Narlıdere Nursing Home Elderly Care and Rehabilitation Center. Elderly people participating in the study were divided into 3 groups: 1. Group, an exercise program consisting of pelvic floor muscle training and OTOGA exercises, 2. Group, only pelvic floor muscle training, and 3. Group, pelvic floor muscle training and Otoga exercises in the form of a digital game program in a portable balance room system. (self-administered) for 12 weeks. Pelvic floor distress inventory (PTDE-20) and bladder diary were used to evaluate the incontinance symptoms of the cases. Pelvic floor muscle function was evaluated with superficial EMG. Berg, Fall Effectiveness Scale (FES) and Functional Status Evaluations (Chair Stand Test, Eight (8) Food Up and Go Test, Chair Sit and Reach Test, Two Minutes Step Test) were used to evaluate balance. The existence of differences between groups was analyzed using Krusskal Wallis analysis of variance, and the difference between before and after exercise was analyzed with Wilcoxon tests. Results: After treatment, PTDE-20, daily urinary incontinence and toilet visits values decreased significantly in all three groups (p < 0.001). While there was a statistically significant increase in pelvic floor muscle EMG values in the 2nd and third groups after treatment, there was no change in the other group (2nd Group PFM average EMG before-after: 5.5 (4.15-10.95) - 10.95 (8.68-13.68), P=0.05, 3 Group PFM average EMG before-after: 6.5 (4.28-11.55) - 11.75 (8.67-14.26), p=0.04). While BERG score, Chair Stand Test, Eight (8) Food Up and Go Test, and Two Minutes Step Test values increased in all groups (p<0.05), Fall Effectiveness Scale (FES) values did not change after treatment. Conclusion: Although pelvic floor muscle training combined with balance exercises reduces symptoms, it may not lead to a positive improvement in the functions of the pelvic floor muscles. For this reason, recovery lasts for a short time, and then symptoms may reoccur in the future. However, thanks to the new system, when balance exercises are combined with a game program for the pelvic floor muscles, a double effect can be achieved with a single application and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on this subject. However, thanks to the new system, a double effect can be achieved with a single application, and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on new system

Keywords: fall, urinary incontinance, balance, elderly

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: Arash Sadeghi, Taimaz Larimian

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This study explores the intricate interplay between community-based social capital (CBSC) and neighbourhood dynamics in enhancing resilience of Iranian SMEs, particularly under the strain of international sanctions. Utilising fuzzy-set Qualitative Comparative Analysis (fsQCA), we examine how different dimensions of CBSC—structural, relational, and cognitive—interact with neighbourhood socio-economic and built-environment characteristics to influence SME resilience. Findings reveal four configurations that contribute to the presence of resistance and five configurations associated with the adaptation outcome. Each configuration demonstrates a distinct combination of social capital elements, which vary according to the specific socio-economic and built-environmental characteristics of the neighbourhoods. The first configuration highlights the importance of structural social capital in deprived areas for building resistance, while the second emphasises the role of relational social capital in low-density, minimally deprived areas. Overall, cognitive social capital seems to be less effective in driving economic resilience compared to structural and relational types. This research contributes to the literature by providing a nuanced understanding of the synergistic effects of CBSC dimensions and neighbourhood characteristics on SME resilience. By adopting a configurational approach, we move beyond traditional methodologies, offering a comprehensive view of the complex dynamics of CBSC and neighbourhood characteristics and their impact on SME resilience in varying neighbourhoods.

Keywords: community-based social capital, fuzzy-set qualitative comparative analysis (fsQCA), place-based resilience, resistance

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Authors: David Adade-Boateng, Benard Fei Baffoe, Colin A. Booth, Michael A. Fullen

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Remediation of diesel fuel, oil and grease in contaminated soils obtained from a mine site in Ghana are explored using rhizoremediation technology with different levels of nutrient amendments (i.e. N (nitrogen) in Compost (0.2, 0.5 and 0.8%), Urea (0.2, 0.5 and 0.8%) and Topsoil (0.2, 0.5 and 0.8%)) for a native species. A Ghanaian native grass species, Paspalum spp. from the Poaceae family, indicative across Sub-Saharan Africa, was selected following the development of essential and desirable growth criteria. Vegetative parts of the species were subjected to ten treatments in a Randomized Complete Block Design (RCBD) in three replicates. The plant-associated microbial community was examined in Paspalum spp. An assessment of the influence of Paspalum spp on the abundance and activity of micro-organisms in the rhizosphere revealed a build-up of microbial communities over a three month period. This was assessed using the MPN method, which showed rhizospheric samples from the treatments were significantly different (P <0.05). Multiple comparisons showed how microbial populations built-up in the rhizosphere for the different treatments. Treatments G (0.2% compost), H (0.5% compost) and I (0.8% compost) performed significantly better done other treatments, while treatments D (0.2% topsoil) and F (0.8% topsoil) were insignificant. Furthermore, treatment A (0.2% urea), B (0.5% urea), C (0.8% urea) and E (0.5% topsoil) also performed the same. Residual diesel and oil concentrations (as total petroleum hydrocarbons, TPH and oil and grease) were measured using infra-red spectroscopy and gravimetric methods, respectively. The presence of single species successfully enhanced the removal of hydrocarbons from soil. Paspalum spp. subjected to compost levels (0.5% and 0.8%) and topsoil levels (0.5% and 0.8%) showed significantly lower residual hydrocarbon concentrations compared to those treated with Urea. A strong relationship (p<0.001) between the abundance of hydrocarbon degrading micro-organisms in the rhizosphere and hydrocarbon biodegradation was demonstrated for rhizospheric samples with treatment G (0.2% compost), H (0.5% compost) and I (0.8% compost) (P <0.001). The same level of amendment with 0.8% compost (N-level) can improve the application effectiveness. These findings have wide-reaching implications for the environmental management of soils contaminated by hydrocarbons in Sub-Saharan Africa. However, it is necessary to further investigate the in situ rhizoremediation potential of Paspalum spp. at the field scale.

Keywords: rhizoremediation, microbial population, rhizospheric sample, treatments

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Authors: Afroza Khatun, Masuma, Md. Younus Mia, Kamal Kanta Das

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Analysis of the microbial status and physicochemical parameters of some branded and street vended ice cream showed that total viable bacteria in branded ice cream ranged from 4.8×10³ to 1.10×10⁵ cfu/ml, and in street vended ice-cream ranged from 7.5×10⁴ to 1.6×10⁸ cfu/ml. Total coliform bacteria present up to 9.20×10³ cfu/ml in branded ice cream and 5.3×10³ to 9.6×10⁶ cfu/ml observed in street vended ice cream. Total E. coli were found to be present within a range from 0 to 4.5×10³ cfu/ml in branded and 4.1×10² to 7.5×10⁴ cfu/ml in street ice cream. The ranges of Staphylococcus aureus count were 1.8×10² to 2.9×10⁴ cfu/ml (branded) and 3.9×10⁴ to 7.9×10⁶ cfu/ml (street). The pH of both types of ice cream showed acidic to neutral conditions where the concentration of pH for branded ice cream was 5.5 to 6.9, as well as the value of pH in street ice cream, was 6.2 to 7.0. The range of Total soluble solids in several branded ice creams was 26 to 29%, and the value of TSS obtained in street-vended ice-creams ranged from 5 to 10%. The overall results of this research demonstrated that the microbial quality in all street ice creams exceeded the BSTI standard and exhibited lower quality than the industrially produced branded ice creams due to comparatively faulty manufacturing processes and poor hygiene practices. The presence of pathogenic microbes was also observed in branded ice creams which was quite alarming for public health. So it is suggested that the government authorized organization should conduct the proper monitoring system to ensure that both branded and street vended ice-creams are microbiologically safe to prevent public health hazards.

Keywords: food safety, microbiological analysis, physicochemical, ice-cream, E. coli, Staphylococcus aureus

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Authors: Adebusoye Michael, Okunola Olayinka, Owolabi Abdulateef, Jacob Anayo

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Introduction: Child undernutrition remains one of Africa’s most fundamental challenges for improved human development because the time and capacities of caregivers are limited; far too many children are unable to access effectively amenities they need for a healthy life. Methods and procedures: This cross-sectional, descriptive study evaluated the maternal care practices on nutritional status of pre-school children, 150 mothers were selected by systematic random sampling in Dass L.G.A., Bauchi-State, Nigeria. Information on relevant parameters were collected by questionaire, analysed by various indices of descriptive statistics using SPSS version 16.0.Spearman’s rank correlation was used to test for associations between the variables. Results: Thirty-five (23.3%) of the respondents were aged 21-25 years. Thirty-three (28.0%) had secondary education, while forty-nine (32.7%) were full housewives. Majority 79(52.7) earned NI,000- N10,000 monthly versus 10(6.7%) who earned N11,000- N20,000.113(75.3%) married while 7(4.7%) of respondents were separated. Sixty-one (40.7%) practiced exclusive breastfeeding within six months. Only seventy-one (47.3%) initiated breastfeeding between 7 and 13 months. Five (3.3%) of children were mildly underweight while nine (6.0%) were severely stunted. Conclusion: The outcome suggested that working time of mothers is a major determinant on their child nutritional status. However, there is a significant relationship on the working time of mothers, income level and educational level of mothers to the nutritional status of their children (P<0.05). Recommendation: Good policy programmes should aim at eradicating poverty, better child care practices that would reduce malnutrition among under-five children.

Keywords: maternal care, nutritional status, preschool children, Dass L.G.A.

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Authors: Rafał Kamiński, Joel Rech, Philippe Bertrand, Christophe Desrayaud

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Titanium alloys are among the most important material in the aircraft industry, due to its low density, high strength, and corrosion resistance. However, these alloys are considered as difficult to machine because they have poor thermal properties and high reactivity with cutting tools. The Selective Laser Melting (SLM) process becomes even more popular through industry since it enables the design of new complex components, that cannot be manufactured by standard processes. However, the high temperature reached during the melting phase as well as the several rapid heating and cooling phases, due to the movement of the laser, induce complex microstructures. These microstructures differ from conventional equiaxed ones obtained by casting+forging. Parts obtained by SLM have to be machined in order calibrate the dimensions and the surface roughness of functional surfaces. The ball milling technique is widely applied to finish complex shapes. However, the machinability of titanium is strongly influenced by the microstructure. So the objective of this work is to investigate the influence of the SLM process, i.e. microstructure, on the machinability of titanium, compared to conventional forming processes. The machinability is analyzed by measuring surface roughness, cutting forces, cutting tool wear for a range of cutting conditions (depth of cut ap, feed per tooth fz, spindle speed N) in accordance with industrial practices.

Keywords: ball milling, microstructure, surface roughness, titanium

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Authors: Phoutsathaphone Sibounheuang, Phayom Sookaneknun Olson, Chanuttha Ploylearmsang, Santiparp Sookaneknun, Chanthanom Manithip

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Patient satisfaction is an outcome that can be measured and used to improve diabetes care and management. There are limited instruments for assessing patient satisfaction covering the whole process of diabetes management. In this study, the questionnaire was developed with items pooled from a systematic review of qualitative studies of patients’ and healthcare providers’ perspectives in diabetes management. The questionnaire consists of 11 domains with 45 items. The Thai version was translated to Lao and then checked by back-translating it into Thai. We tested the questionnaire on 150 diabetes patients in Thailand and 150 in Lao People Democratic Republic (PDR). Validity was performed by factor analysis and Pearson correlation. Internal consistency reliability was estimated by calculating Cronbach’s alpha. The study was approved by the Mahasarakham University Ethics Committee, and the National Ethics Committee for Health Research, Lao PDR. The Thai and Lao versions showed the construct validity by principal component analysis. This consisted of 11 domains which account for 71.23% of the variance (Thai version) and 71.66% of the variance (Lao version) in the total patient satisfaction scores. The Kaiser-Meyer-Olkin (KMO) measures were 0.85 for the Thai version and 0.75 for the Lao version. The Bartlett tests of sphericity of both versions were significant (p < 0.001). The factor loadings of all items in both versions were > 0.40. The convergent validity of the Thai and Lao versions was 93.63% and 79.54% respectively. The discriminant validity for the Thai and Lao versions was 92.68% and 88.68% respectively. Cronbach’s alpha was 0.95 in both versions. The Patient Satisfaction Questionnaire (PSQ) in both versions had acceptable properties. This study has yielded evidence supporting the validity and reliability of both versions.

Keywords: construct validity, diabetes management, patient satisfaction, questionnaire development, reliability

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Authors: Sreeja Shaw, Prosenjit Samanta, Asish Kumar Mukhopadhyay

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Cholera is still a global public health burden and is caused by Vibrio cholerae O1 and O139 serogroups. Evidence from recent outbreaks in Haiti and Yemen suggested that circulating V. cholerae O1 El Tor variant strains are continuously changing to cause more ruinous outbreaks worldwide, and most of them have emerged from the Indian subcontinents. Therefore, we studied the changing virulence characteristics along with the antibiotic resistance profile of V. cholerae O1strains isolated from seasonal outbreaks in three cholera endemic regions during 2018, Gujarat and Maharashtra in Western India (87 strains), and to compare those features with the isolates of West Bengal in Eastern India (48 strains) collected during the same period. All the strains from Western India were of Ogawa serotype, polymyxin B-sensitive, hemolytic, and contained a large fragment deletion in VSP-II genomic region similar with Yemen outbreak strains and carried more virulent Haitian genetic alleles of major virulence associated genes ctxB, tcpA, and rtxA. Conversely, 14.6% (7/48) of the strains from Eastern India were belong to the Inaba serotype, polymyxin B-resistant, non-hemolytic, harbored intact VSP-II region, classical ctxB, Haitian tcpA, and El Tor rtxA alleles. Interestingly, resistance to tetracycline and chloramphenicol was seen in isolates from both regions, which are not very common among V. cholerae O1 isolates in India. Therefore, this study indicated West Bengal as a diverse region where two different types of El Tor variant hypervirulent strains are co-existed, probably competing for their better environmental survival, which may result in severe irrepressible disease outcome in the future.

Keywords: cholera, vibrio cholerae, polymyxin B, Non-hemolytic, ctxB, tcpA, rtxA, VSP-II

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Authors: Soudeh Tabashi, Mohammadreza Moshari, Parisa Sezari

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Introduction: Postoperative analgesia in Orthotopic Liver Transplantation (OLT) surgery is challenging for anesthesiologists. Although OLT is one of the most extensive abdominal operations, it seems that patients don’t suffer from severe post operative pain. On the other hands drug metabolism is unpredictable due to unknown graft function. The aim of this study was to compare intraoperative infusion of remifentanil versus fentanyl in postoperative opioid demand in patients with OLT and evaluating the complications in two groups. Method: In this double-blind clinical trial 34 patients who had OLT were included. They divided randomly in two groups of Remifentanil (R) and Fentanyl (F). Patients in group R and F received infusion of Remifentanil 0.3-1 µg/Kg/min and Fentanyl 0.3-1 µg/Kg/min during maintenance of anesthesia. Post operative pain were measured in 6, 12, 18, 24 hours and second and third days after surgery with Numeric Rate Scale (NRS). Patients had received intravenous acetaminophen as rescue therapy with NRS of 3 or more. In addition to demographic information, post operative opioid consumption were recorded as the primary outcome. Intraoperative blood transfusion, intraoperative inotropic drugs consumption, weaning time and intensive care unit stay were also evaluated. Results: Total dose of acetaminophen consumption in first 3 days after surgery did not have significant difference between two groups (Pvalue=0.716). intraoperative inotrope consumption, blood transfusion and post operative weaning time and ICU stay were also similar in both groups. Conclusion: This study demonstrates that intraoperative infusion of remifentanil in OLT have the same effect on post operative pain management as fentanyl. Despite the complications of operation were not increased by remifentanil.

Keywords: liver transplantation, postoperative pain, remifentanil, fentanyl

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