Search results for: Breast Dose
Commenced in January 2007
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Edition: International
Paper Count: 1978

Search results for: Breast Dose

1228 Management Problems in a Patient With Long-term Undiagnosed Permanent Hypoparathyroidism

Authors: Babarina Maria, Andropova Margarita

Abstract:

Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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1227 Effect of Oral Administration of "Gadagi" Tea on Activities of Some Antioxidant Enzymes in Rats

Authors: A. M. Gadanya, M. S. Sule

Abstract:

Effect of oral administration of Gadagi tea on some antioxidant enzymes was assessed in healthy male albino rats. The rats were grouped and administered with standard doses of the 3 types of Gadagi tea i.e. Sak, Sada and Magani for a period of four weeks. Animals that were not administered with the tea constituted the control group. At the end of fourth week, the animals were sacrificed and their serum superoxide dismutase (SOD), glutathione reductase (GR) and catalase (CAT) activities were determined. The activities of the enzymes were also determined in the brain, liver, kidney and intestine homogenates of the rats. Mean SOD activity in brain of rats orally administered with “sada” was found to be significantly higher (P < 0.05) than that of the control group. Mean CAT activity in the intestine of rats orally administered with “magani” was found to be significantly higher (P < 0.05) than that of the control group and the experimental groups of Sak and Sada at standard dose level. Thus, all the “Gadagi” tea preparations studied at standard dose level could stimulate antioxidant enzymes, especially SOD in brain and CAT in intestine (by Sada) and CAT in intestine (by Magani).

Keywords: “Gadagi” tea, superoxide dismutase, catalase, glutathione reductase

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1226 Morroniside Intervention Mechanism of Renal Lesions, a Combination Model of AGEs Exacerbation of STZ-Induced Diabetes Mellitus

Authors: Hui-Qin Xu, Xing Lv, Yu-Han Tao

Abstract:

The depth study aimed on the mechanism of morroniside in protecting diabetic nephropathy. The diabetic mice models with blood glucose above 15mmol/L were divided into model, aminoguanidine, metformin, captopril, morroniside low-dose, and morroniside high-dose groups. And normal group was set simultaneously. All groups were fed with high AGEs food except normal group. Each group was intragastric administration of the corresponding medicine except model and normal groups. After 12 weeks, all the indictors were measured. It showed that the morroniside could reduce blood glucose significantly, urinary protein, serum urea nitrogen, creatine, pathological changes, AGEs levels, renal cortex RAGE mRNA and RAGE protein expression levels; increase food consumption, water intake, urine volume, insulin secretion. As a conclusion, morroniside from cornus officinalis can protect renal in diabetic mice, its mechanism may be related to the proliferation of islet cells, rectify glycometabolism, reduce serum and kidney AGEs content, and descend renal RAGEmRNA and RAGE protein expression levels.

Keywords: cornus officinalis, diabetic nephropathy, morroniside, RAGE protein

Procedia PDF Downloads 436
1225 Application Difference between Cox and Logistic Regression Models

Authors: Idrissa Kayijuka

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The logistic regression and Cox regression models (proportional hazard model) at present are being employed in the analysis of prospective epidemiologic research looking into risk factors in their application on chronic diseases. However, a theoretical relationship between the two models has been studied. By definition, Cox regression model also called Cox proportional hazard model is a procedure that is used in modeling data regarding time leading up to an event where censored cases exist. Whereas the Logistic regression model is mostly applicable in cases where the independent variables consist of numerical as well as nominal values while the resultant variable is binary (dichotomous). Arguments and findings of many researchers focused on the overview of Cox and Logistic regression models and their different applications in different areas. In this work, the analysis is done on secondary data whose source is SPSS exercise data on BREAST CANCER with a sample size of 1121 women where the main objective is to show the application difference between Cox regression model and logistic regression model based on factors that cause women to die due to breast cancer. Thus we did some analysis manually i.e. on lymph nodes status, and SPSS software helped to analyze the mentioned data. This study found out that there is an application difference between Cox and Logistic regression models which is Cox regression model is used if one wishes to analyze data which also include the follow-up time whereas Logistic regression model analyzes data without follow-up-time. Also, they have measurements of association which is different: hazard ratio and odds ratio for Cox and logistic regression models respectively. A similarity between the two models is that they are both applicable in the prediction of the upshot of a categorical variable i.e. a variable that can accommodate only a restricted number of categories. In conclusion, Cox regression model differs from logistic regression by assessing a rate instead of proportion. The two models can be applied in many other researches since they are suitable methods for analyzing data but the more recommended is the Cox, regression model.

Keywords: logistic regression model, Cox regression model, survival analysis, hazard ratio

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1224 Neuroprotective Effect of Vildagliptin against Cerebral Ischemia in Rats

Authors: Salma A. El-Marasy, Rehab F. Abdel-Rahman, Reham M. Abd-Elsalam

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The burden of stroke is intensely increasing worldwide. Brain injury following transient or permanent focal cerebral ischemia develops ischemic stroke as a consequence of a complex series of pathophysiological events. The aim of this study is to evaluate the possible neuroprotective effect of a dipeptidyl peptidase-4 inhibitor, vildagliptin, independent on its insulinotropic properties in non-diabetic rats subjected to cerebral ischemia. Anaesthetized Wistar rats were subjected to either left middle cerebral artery occlusion (MCAO) or sham operation followed by reperfusion after 30 min of MCAO. The other three groups were orally administered vildagliptin at 3 dose levels (2.5, 5, 10 mg/kg) for 3 successive weeks before subjected to left focal cerebral ischemia/reperfusion and till the end of the study. Neurological deficit scores and motor activity were assessed 24h following reperfusion. 48h following reperfusion, rats were euthanized and their left brain hemispheres were harvested and used in the biochemical, histopathological, and immunohistochemical investigations. Vildagliptin pretreatment improved neurological score deficit, locomotor activity and motor coordination in MCAO rats. Moreover, vildagliptin reduced malondialdehyde (MDA), elevated reduced glutathione (GSH), phosphotylinosital 3 kinase (PI3K), phosphorylated of protein kinase B (p-AKT), and mechanistic target of rapamycin (mTOR) brain contents in addition to reducing protein expression of caspase-3. Also, vildagliptin showed a dose-dependent attenuation in neuronal cell loss and histopathological alterations in MCAO rats. This study proves that vildagliptin exerted the neuroprotective effect in a dose-dependent manner as shown in amelioration of neuronal cell loss and histopathological damage in MCAO rats, which may be mediated by attenuating neuronal and motor deficits, it’s anti-oxidant property, activation of PI3K/AKT/mTOR pathway and its anti-apoptotic effect.

Keywords: caspase-3, cerebral ischemia, dipeptidyl peptidase-4 inhibitor, oxidative stress, PI3K/AKT/mTOR pathway, rats, vildagliptin

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1223 Influence of Biochar Application on Growth, Dry Matter Yield and Nutrition of Corn (Zea mays L.) Grown on Sandy Loam Soils of Gujarat, India

Authors: Pravinchandra Patel

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Sustainable agriculture in sandy loam soil generally faces large constraints due to low water holding and nutrient retention capacity, and accelerated mineralization of soil organic matter. There is need to increase soil organic carbon in the soil for higher crop productivity and soil sustainability. Recently biochar is considered as sixth element and work as a catalyst for increasing crop yield, soil fertility, soil sustainability and mitigation of climate change. Biochar was generated at the Sansoli Farm of Anand Agricultural University, Gujarat, India by pyrolysis at temperatures (250-400°C) in absence of oxygen using slow chemical process (using two kilns) from corn stover (Zea mays, L), cluster bean stover (Cyamopsis tetragonoloba) and Prosopis julifera wood. There were 16 treatments; 4 organic sources (3 biochar; corn stover biochar (MS), cluster bean stover (CB) & Prosopis julifera wood (PJ) and one farmyard manure-FYM) with two rate of application (5 & 10 metric tons/ha), so there were eight treatments of organic sources. Eight organic sources was applied with the recommended dose of fertilizers (RDF) (80-40-0 kg/ha N-P-K) while remaining eight organic sources were kept without RDF. Application of corn stover biochar @ 10 metric tons/ha along with RDF (RDF+MS) increased dry matter (DM) yield, crude protein (CP) yield, chlorophyll content and plant height (at 30 and 60 days after sowing) than CB and PJ biochar and FYM. Nutrient uptake of P, K, Ca, Mg, S and Cu were significantly increased with the application of RDF + corn stover @ 10 metric tons/ha while uptake of N and Mn were significantly increased in RDF + corn stover @ 5 metric tons/ha. It was found that soil application of corn stover biochar @ 10 metric tons/ha along with the recommended dose of chemical fertilizers (RDF+MS ) exhibited the highest impact in obtaining significantly higher dry matter and crude protein yields and larger removal of nutrients from the soil and it also beneficial for built up nutrients in soil. It also showed significantly higher organic carbon content and cation exchange capacity in sandy loam soil. The lower dose of corn stover biochar @ 5 metric tons/ha (RDF+ MS) was also remained the second highest for increasing dry matter and crude protein yields of forage corn crop which ultimately resulted in larger removals of nutrients from the soil. This study highlights the importance of mixing of biochar along with recommended dose of fertilizers on its synergistic effect on sandy loam soil nutrient retention, organic carbon content and water holding capacity hence, the amendment value of biochar in sandy loam soil.

Keywords: biochar, corn yield, plant nutrient, fertility status

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1222 A Review of Deep Learning Methods in Computer-Aided Detection and Diagnosis Systems based on Whole Mammogram and Ultrasound Scan Classification

Authors: Ian Omung'a

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Breast cancer remains to be one of the deadliest cancers for women worldwide, with the risk of developing tumors being as high as 50 percent in Sub-Saharan African countries like Kenya. With as many as 42 percent of these cases set to be diagnosed late when cancer has metastasized and or the prognosis has become terminal, Full Field Digital [FFD] Mammography remains an effective screening technique that leads to early detection where in most cases, successful interventions can be made to control or eliminate the tumors altogether. FFD Mammograms have been proven to multiply more effective when used together with Computer-Aided Detection and Diagnosis [CADe] systems, relying on algorithmic implementations of Deep Learning techniques in Computer Vision to carry out deep pattern recognition that is comparable to the level of a human radiologist and decipher whether specific areas of interest in the mammogram scan image portray abnormalities if any and whether these abnormalities are indicative of a benign or malignant tumor. Within this paper, we review emergent Deep Learning techniques that will prove relevant to the development of State-of-The-Art FFD Mammogram CADe systems. These techniques will span self-supervised learning for context-encoded occlusion, self-supervised learning for pre-processing and labeling automation, as well as the creation of a standardized large-scale mammography dataset as a benchmark for CADe systems' evaluation. Finally, comparisons are drawn between existing practices that pre-date these techniques and how the development of CADe systems that incorporate them will be different.

Keywords: breast cancer diagnosis, computer aided detection and diagnosis, deep learning, whole mammogram classfication, ultrasound classification, computer vision

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1221 Numerical Response of Planar HPGe Detector for 241Am Contamination of Various Shapes

Authors: M. Manohari, Himanshu Gupta, S. Priyadharshini, R.Santhanam, S.Chandrasekaran, B|.Venkatraman

Abstract:

Injection is one of the potential routes of intake in a radioactive facility. The internal dose due to this intake is monitored at the radiation emergency medical centre, IGCAR using a portable planar HPGe detector. The contaminated wound may be having different shapes. In a reprocessing potential of wound contamination with actinide is more. Efficiency is one of the input parameters for estimation of internal dose. Estimating these efficiencies experimentally would be tedious and cumbersome. Numerical estimation can be a supplement to experiment. As an initial step in this study 241Am contamination of different shapes are studied. In this study portable planar HPGe detector was modeled using Monte Carlo code FLUKA and the effect of different parameters like distance of the contamination from the detector, radius of the circular contamination were studied. Efficiency values for point and surface contamination located at different distances were estimated. The effect of efficiency on the radius of the surface source was more predominant when the source is at 1 cm distance compared to when the source to detector distance is 10 cm. At 1 cm the efficiency decreased quadratically as the radius increased and at 10 cm it decreased linearly. The point source efficiency varied exponentially with source to detector distance.

Keywords: Planar HPGe, efficiency value, injection, surface source

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1220 Silymarin Loaded Mesoporous Silica Nanoparticles: Preparation, Optimization, Pharmacodynamic and Oral Multi-Dose Safety Assessment

Authors: Sarah Nasr, Maha M. A. Nasra, Ossama Y. Abdallah

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The present work aimed to prepare Silymarin loaded MCM-41 type mesoporous silica nanoparticles (MSNs) and to assess the system’s solubility enhancement ability on the pharmacodynamic performance of Silymarin as a hepatoprotective agent. MSNs prepared by soft-templating technique, were loaded with Silymarin, characterized for particle size, zeta potential, surface properties, DSC and XRPD. DSC and specific surface area data confirmed deposition of Silymarin in an amorphous state in MSNs’ pores. In-vitro drug dissolution testing displayed enhanced dissolution rate of Silymarin upon loading on MSNs. High dose Acetaminophen was then used to inflict hepatic injury upon albino male Wistar rats simultaneously receiving either free Silymarin, Silymarin loaded MSNs or blank MSNs. Plasma AST, ALT, albumin and total protein and liver homogenate content of TBARs or LDH as measures of antioxidant drug action were assessed for all animal groups. Results showed a significant superiority of Silymarin loaded MSNs to free drug in almost all parameters. Meanwhile prolonged administration of blank MSNs had no evident toxicity on rats.

Keywords: mesoporous silica nanoparticles, safety, solubility enhancement, silymarin

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1219 A Randomised, Single-Dose, Two-Period, Cross-Over Phase I Pharmacokinetic Study to Compare TDS®-Diazepam with Rectal Diazepam in Healthy Adult Subjects

Authors: Faisal O. Al-Otaibi, Arthur T. Tucker, Richard M. Langford, Stuart Ratcliffe, Atholl Johnston, Terry D. Lee, Kenneth B. Kirby, Chandan A. Alam

Abstract:

The Transdermal Delivery System (TDS®) is a proprietary liquid formulation that can be applied to intact skin via a metered pump spray to facilitate drug delivery to the circulation. The aim of this study was to assess the ability of the TDS preparation to deliver diazepam systemically, and to characterize the pharmacokinetic profile of the drug in healthy adult subjects. We conducted a randomized, single-dose, two-period, crossover phase I (pharmacokinetic) comparative study in twelve healthy volunteers. All volunteers received both 10 mg TDS-diazepam topically to the upper chest and 10 mg of the rectal diazepam preparation (Diastat®, 10 mg diazepam gel), with a minimum washout of 14 days between dosing episodes. Both formulations were well tolerated in all volunteers. Following topical application of TDS-diazepam, the mean AUC0-72h was 1241 ng/mL.h and the Cmax 34 ng/mL. The values for rectal Diastat were 4109 ng/mL.h and 300 ng/mL respectively. This proof of concept study demonstrates that the TDS preparation successfully delivered diazepam systemically to adults. As expected, the concentration of diazepam following the TDS application was lower and not bioequivalent to rectal gel. Future development of this unique system is required.

Keywords: transdermal delivery system, diazepam, seizure, bioequivalence, pharmacokinetic

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1218 Concurrent Micronutrient Deficiencies in Lactating Mothers and Their Infants 6-23 Months of Age in Two Agro-Ecological Zones of Rural Ethiopia

Authors: Kedir Teji Roba, Thomas P. O’Connor, Tefera Belachew, Nora M. O’Brien

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Micronutrient deficiencies of ferritin, zinc and haemoglobin are prevalent among the mothers and their infants in developing countries. But little attention has been given to these vulnerable groups. No study has been done on co-existence of the deficiencies among lactating mothers and their breast feeding infants in two different agro-ecological zones of rural Ethiopia. Methods: Data were collected from 162 lactating mothers and their breast feeding infants (aged 6-23 months) who were living in two different agro-ecological zones. The data were collected via a structured interview, anthropometric measurements, and blood test for Zinc, ferritin and anaemia. Correlation and Chi square test were used to determine the association among nutritional status and agro ecological zones. Results: Iron deficiency was found in 44.4% of the infants and 19.8% of the mothers. Zinc deficiency was found in 72.2% of the infants and 67.3% of the mothers. Of the study subject 52.5% of the infants and 19.1% of the mothers were anaemic, and 29.6% of the infants and 10.5% of the mothers had iron deficiency anaemia. Among the mothers with iron deficiency, 81.2% and 56.2% of their children were deficient in zinc and iron respectively. Similarly, among the zinc deficient mothers, 75.2% and 45.3% of their children were deficient in zinc and iron. There was a strong correlation between the micronutrient status of the mothers and the infants on status of ferritin, zinc and anaemia (P < 0.001). There is also statistically significant association between micronutrient deficiency and agro-ecological zones among the mothers (p < 0.001) but not with their infants. Deficiency in one, two, or three, micronutrients was observed in 48.1%, 16.7% and 9.9% of the mothers and 35.8%, 29.0%, and 23.5%, of their infants respectively. Conclusion: This study shows that iron and zinc deficiencies are the prevalent micronutrient deficiencies among the lactating mothers and their infants, with variation of the magnitude across the agro-ecological zones. This finding calls for a need to design effective preventive public health nutrition programs to address both the mothers’ and their infants’ needs.

Keywords: ferritin/iron, zinc, anaemia, agroecology, malnutrition

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1217 Comparison of the Effect of Two Rootstocks Citrus Macrophylla and Citrus Volkameriana on Water Productivity of Citrus “Orogrande” Under Three Irrigation Doses

Authors: Hicham Elomari, Absa Fall, Taoufiq Elkrochni

Abstract:

This present work mainly concerns the improvement of citrus water productivity in the Souss Massa region. The objective is to evaluate the effect of deficit irrigation applied during the fruit growth stage on fruit size, quality and yield of the Orogrande variety grafted on Citrus macrophylla and Citrus volkameriana. Three irrigation regimes were adopted, a control D0 of 3.6 l/h and two doses D1 (58% D0 =2.1 l/h) and D2 (236% D0 =8.5 l/h). The experimental design was a randomized complete block while keeping the same spacing between drippers, the same duration of irrigation and the beginning of trials (fruit growth stage). Results showed that at the end of the cycle from October 1, 2020, to September 30, 2021, a total water supply of 732 mm and 785 mm using the D1 dose was provided to trees of Orogrande variety, respectively grafted on Citrus macrophylla and Citrus volkameriana rootstocks. Citrus macrophylla presented largest fruit size of 38 mm compared to Citrus volkameriana (33mm) with a significant difference. Total soluble sugar (8°Brix) and juice content level (40%) were higher with the application of the D1 dose on both rootstocks. Yield of 36 Tons was not affected by the deficit irrigation. Reduction of water supply by 18% increases agronomic productivity (6 MAD/m³) and economic productivity (3 MAD/m³).

Keywords: citrus, irrigation, fruit size, fruit quality, yield

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1216 Toxicity of Biopesticide Metarhizium anisopliae var acridium "Green Muscle" on the Cuticle of the Desert Locust Schistocerca gegaria (Forskål, 1775)

Authors: F. Haddadj, F. Acheuk, S. Hamdi, S. Zenia, A. Smai, H. Saadi, B. Doumandji-Mitiche

Abstract:

Locust is causing significant losses in agricultural production in the countries concerned by the invasion. Up to the present control strategy has consisted only of the spreaders chemicals; they have proven harmful to the environment and. For this, a new control method appeared it comes to the biological control based mostly by using microorganism. It is in that sense is we've made our contribution by the use of a biopesticide which is entomopathogenic fungus Metarhizium anisopliae var acridium "Green Muscle" on part of the cuticule the larval of fifth instar locust Schistocerca gregaria (Forskål, 1775). Preliminary test on the study of the pathogenicity of M. anisopliae var acridium biocontrol agent, was conducted in the laboratory on L5 S. gregaria, on which we inoculated treatment in the digestive tract and it administrant 20μl of entomopathogenic solution orally at a dose DL50 = 3.25 x107 sp./ ml (median lethal dose estimated at earlier), 5 days after treatment individuals are sacrificed. After dissection cuticles are recovered and then subjected to histological sections. The histological technique followed is that of Martoja Martoja-Pierson (1967). Microscopic observation revealed alterations in the architecture of the cuticule which leads to disorganization of cell layers.

Keywords: biopesticide, cuticle, desert locust, toxicity

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1215 In vivo Evidence of Protective Effect of Hyparrhenia Hirta against Nitrate-Induced Genotoxicity

Authors: H. Bouaziz-Ketata, G. Ben Salah, Z. Aidi, C. Kallel, H. Kammoun, F. Fakhfakh, N. Zeghal

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The present study was performed to evaluate the potential protective effect of Hyparrhenia hirta methanolic extract in NaNO3-induced genotoxic and hematotoxic effects. Male Wistar rats were randomly divided into three groups: a control group and two treated groups during 50 days with NaNO3 administered at a dose of 400 mg kg-1 bw either alone in drinking water or co-administered with Hyparrhenia hirta at a dose of 200 mg kg-1 bw. NaNO3 treatment showed a significant increase in the frequencies of total chromosomal aberrations, aberrant metaphases and micronucleus in bone-marrow cells. In parallel, the NaNO3-treated group showed a significant decrease in red blood cell count, hemoglobin and hematocrit and a significant increase in total white blood cell, in neutrophil and eosinophil counts. Platelet count, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration remained unchanged in treated groups compared to those of controls. Hyparrhenia hirta methanolic extract appeared to be effective against genotoxic and hematotoxic changes induced by nitrate, as evidenced by the improvement of the markers cited above.

Keywords: Hyparrhenia hirta, sodium nitrate, erythrocytes, genotoxicity

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1214 Experimental Lead Toxicity in Lohi Sheep: Risks and Impact on Edible Tissues

Authors: Muhammad Younus, Muhammad Sajid, Muti-ur-Rehman Khan, Aftab Ahmad Anjum, Muhammad Asif Idrees, Iahtasham Khan, Aman Ullah Khan, Sajid Umar, Raheela Akhtar

Abstract:

The present study was conducted to investigate the hazardous effects of lead on health and edible organs of Lohi sheep. The adult Lohi sheep (n=48) were randomly divided into two equal groups. The first group was administered lead acetate at dose of 70 mg/kg live body weight daily as 10% solution by oral route for a period of 90 days and the second group served as a negative control. Blood and tissue samples were collected at day 0, 30, 60 and 90 and analyzed for lead concentration by atomic absorption spectrophotometry. The kidney showed the highest lead concentration (p < 0.05) followed by liver and then muscle. Lead acetate treated sheep showed structural and behavioral changes during the last month of trial. Liver showed necrosis, hemorrhages and hyperactivation of macrophages. Kidney showed degenerative and necrotic changes in glomeruli and tubules and the characteristic intranuclear inclusion bodies in tubular epithelial cells on H and E staining. It was concluded that Lohi sheep is affected by lead intoxication at low dose for longer period and hence exhibits lead accumulation in edible tissues.

Keywords: Lohi sheep, lead acetate, edible tissue, histopathology

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1213 Ameliorating Effects of Rosemary and Costus on Blood-Associated Toxicity in Ehrlich-Bearing Mice Treated with Cisplatin

Authors: Yousry El-Sayed Elbolkiny, Mohamed Labib Salem

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Background: Rosemary (ROLE) and costus (SLRE) have been established to show antioxidant effects. Aim: This study aimed to evaluate the ameliorating effects of ROLE and SLRE on the side effects induced by cisplatin (CIS) in tumor-bearing mice. Materials and Methods: Extracts of ROLE and SLRE were examined for their phytochemical activities. To evaluate their anti-tumor effects, mice were inoculated intraperitoneally (i.p.) with 2.5x105 Ehrlich ascites carcinoma (EAC) and then treated i.p. with CIS at days 3-7 and with ROLE (dose) or SLRE (dose) at days 3-14. Mice were sacrificed on day 14 for CBC and T-cell analyses. Results: Phytochemical analysis revealed that both ROLE and SLRE showed similar antioxidant activities. Treatment of EAC-bearing mice with CIS-induced antitumor efficacy of about 90%. Treatment with CIS in combination with ROLE or SLRE did not further enhance the antitumor activity of CIS. However, co-administration of ROLE or SLRE with CIS significantly increased the antitumor efficacy of CIS. Flow cytometric analysis showed that the numbers of CD4+ and CD8+ T cells were decreased in EAC-bearing mice after treatment with CIS. Treatment with both ROLE and SLRE improved the number of these cells. Conclusion: Combinatorial treatment with rosemary and costus can enhance the antitumor activity of CIS

Keywords: CBC, cisplantin, costus, rosemary

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1212 Binding Mechanism of Synthesized 5β-Dihydrocortisol and 5β-Dihydrocortisol Acetate with Human Serum Albumin to Understand Their Role in Breast Cancer

Authors: Monika Kallubai, Shreya Dubey, Rajagopal Subramanyam

Abstract:

Our study is all about the biological interactions of synthesized 5β-dihydrocortisol (Dhc) and 5β-dihydrocortisol acetate (DhcA) molecules with carrier protein Human Serum Albumin (HSA). The cytotoxic study was performed on breast cancer cell line (MCF-7) normal human embryonic kidney cell line (HEK293), the IC50 values for MCF-7 cells were 28 and 25 µM, respectively, whereas no toxicity in terms of cell viability was observed with HEK293 cell line. The further experiment proved that Dhc and DhcA induced 35.6% and 37.7% early apoptotic cells and 2.5%, 2.9% late apoptotic cells respectively. Morphological observation of cell death through TUNEL assay revealed that Dhc and DhcA induced apoptosis in MCF-7 cells. The complexes of HSA–Dhc and HSA–DhcA were observed as static quenching, and the binding constants (K) was 4.7±0.03×104 M-1 and 3.9±0.05×104 M-1, and their binding free energies were found to be -6.4 and -6.16 kcal/mol, respectively. The displacement studies confirmed that lidocaine 1.4±0.05×104 M-1 replaced Dhc, and phenylbutazone 1.5±0.05×104 M-1 replaced by DhcA, which explains domain I and domain II are the binding sites for Dhc and DhcA. Further, CD results revealed that the secondary structure of HSA was altered in the presence of Dhc and DhcA. Furthermore, the atomic force microscopy and transmission electron microscopy showed that the dimensions like height and molecular sizes of the HSA–Dhc and HSA–DhcA complex were larger compared to HSA alone. Detailed analysis through molecular dynamics simulations also supported the greater stability of HSA–Dhc and HSA–DhcA complexes, and root-mean-square-fluctuation interpreted the binding site of Dhc as domain IB and domain IIA for DhcA. This information is valuable for the further development of steroid derivatives with improved pharmacological significance as novel anti-cancer drugs.

Keywords: apoptosis, dihydrocortisol, fluorescence quenching, protein conformations

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1211 Effect Of Tephrosia purpurea (Family: Fabaceae) Formulations On Oviposition By The Pulse Beetle Callosobruchus chinensis Linn.

Authors: Priyanka Jain, Meera Srivastava

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Among important insect pests of stored grains, the pulse beetle Callosobruchus chinensis Linn. (Coleoptera: Bruchidae) is one such pest causing considerable damage to stored pulses. An effort was made to screen plant Tephrosia purpurea (Family: Fabaceae) for its efficacy against the said pest. The pulse beetle C. chinensis was raised on green gram Vigna radiata in incubators maintained at 28 ± 2°C and 70% RH. Different formulations using plant parts (root, stem, leaf and fruit) were employed in the form of aqueous suspension, aqueous extract and ether extract and the treatments were made using different dose concentrations, namely 1%, 2.5%, 5% and 10%, besides normal and control. Specific number of adult insects were released in muslin cloth covered beakers containing weighed green gram grains and treated with different dose concentrations (w/v). Observations for the number of eggs laid by the pest insect C. chinensis was recorded after three days of treatment and it was observed that in general all the treatments of the plant resulted in significant decrease in the eggs laid (no/pair) by the insect, suggesting that the selected plant has a potential to be used against C. chinensis.

Keywords: Callosobruchus chinensis, egg laying, Tephrosia purpurea, Fabaceae, plant formulations

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1210 Computer Assisted Strategies Help to Pharmacist

Authors: Komal Fizza

Abstract:

All around the world in every field professionals are taking great support from their computers. Computer assisted strategies not only increase the efficiency of the professionals but also in case of healthcare they help in life-saving interventions. The background of this current research is aimed towards two things; first to find out if computer assisted strategies are useful for Pharmacist for not and secondly how much these assist a Pharmacist to do quality interventions. Shifa International Hospital is a 500 bedded hospital, and it is running Antimicrobial Stewardship, during their stewardship rounds pharmacists observed that a lot of wrong doses of antibiotics were coming at times those were being overlooked by the other pharmacist even. So, with the help of MIS team the patients were categorized into adult and peads depending upon their age. Minimum and maximum dose of every single antibiotic present in the pharmacy that could be dispensed to the patient was developed. These were linked to the order entry window. So whenever pharmacist would type any order and the dose would be below or above the therapeutic limit this would give an alert to the pharmacist. Whenever this message pop-up this was recorded at the back end along with the antibiotic name, pharmacist ID, date, and time. From 14th of January 2015 and till 14th of March 2015 the software stopped different users 350 times. Out of this 300 were found to be major errors which if reached to the patient could have harmed them to the greater extent. While 50 were due to typing errors and minor deviations. The pilot study showed that computer assisted strategies can be of great help to the pharmacist. They can improve the efficacy and quality of interventions.

Keywords: antibiotics, computer assisted strategies, pharmacist, stewardship

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1209 Texture Analysis of Grayscale Co-Occurrence Matrix on Mammographic Indexed Image

Authors: S. Sushma, S. Balasubramanian, K. C. Latha

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The mammographic image of breast cancer compressed and synthesized to get co-efficient values which will be converted (5x5) matrix to get ROI image where we get the highest value of effected region and with the same ideology the technique has been extended to differentiate between Calcification and normal cell image using mean value derived from 5x5 matrix values

Keywords: texture analysis, mammographic image, partitioned gray scale co-oocurance matrix, co-efficient

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1208 Effect of High Dose of Black Tea Extract on Physiological Parameters of Mother and Pups in Experimental Albino Rats

Authors: Avijit Dey, Antony Gomes, Subir Chandra Dasgupta

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Tea (Camellia sinensis) is the most popular beverages in the world and is ranked second after the water. Tea has been considered as a health promoting beverage since ancient times due to its health-promoting activity. Recently, immunomodulatory, anti-arthritic, antioxidant, anticancer and cardioprotective activity of tea has been established. Very few studies have demonstrated the effect of high dose of black tea on health. The aim of the present study was to evaluate the role of low & high dose of Black Tea Extract (BTE) on the different physiological parameters of mother and pups during prenatal and postnatal developmental period in the experimental rodent. BTE was orally administered in LD (50mg BTE/kg/day) and HD (100mg BTE/kg/day) except control groups of rats (n=6/group) throughout the prenatal (day 0-21) and postnatal (day 21-42) periods. During prenatal period (0, 7th, 14th, 20th days) body weight, urinary calcium, magnesium, urea and creatinine was measured. In postnatal period physical (0, 10th, 21th days) parameters of pups like body weight, cranial length, cranial diameter, neck width, tail length, craniosacral length of pups were analyzed. Liver and lungs from pups and kidney spleen, etc. from mothers were collected on day 42 for histopathological studies. The comparative urine strip and morphology of RBC was also analyzed by SEM from mothers of different groups on day 42. The level of cytokines like IL-1alpha, IL-1beta, IL-6, IL-10, TNF-alpha were analysed by enzyme-linked immunosorbent assay (ELISA) on day 0, day 20 and day 42. The body weight of LD and HD mothers were also significantly (P<0.05) less than control mothers at 20th day of pregnancy and there was also significant changes in urinary calcium, urea, creatinine. The bio morphometric analysis of pups showed significant alteration (P<0.05) in HD groups relative to control. Some histological alterations were also observed in pups and mothers. Comparative urine strip analysis and morphology of RBC showed significant changes in treated groups. LD and HD treated mothers showed an increase in proinflammatory cytokines like IL-1beta, TNF-alpha and decrease in anti-inflammatory cytokine-like IL-10 on day 20 compared to PC mothers. This study clearly indicated that high dose of BTE possesses detrimental effect on pregnant mother and the pup. Further studies are in progress to elucidate the molecular mechanism of actions. This project work has been sponsored by National Tea Research Foundation vide Project Sanction No.: 17 (305)/2013/4423 dated 11th March, 2014. All experimental protocols described in the study were approved by animal ethics committee.

Keywords: black tea extract, pregnancy, prenatal and postnatal development, inflammation

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1207 Purification of Bilge Water by Adsorption

Authors: Fatiha Atmani, Lamia Djellab, Nacera Yeddou Mezenner, Zohra Bensaadi

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Generally, bilge waters can be briefly defined as saline and greasy wastewaters. The oil and grease are mixed with the sea water, which affects many marine species. Bilge water is a complex mixture of various compounds such as solvents, surfactants, fuel, lubricating oils, and hydraulic oils. It is resulted mainly by the leakage from the machinery and fresh water washdowns,which are allowed to drain to the lowest inner part of the ship's hull. There are several physicochemical methods used for bilge water treatment such as biodegradation electrochemical and electro-coagulation/flotation.The research herein presented discusses adsorption as a method to treat bilge water and eggshells were studied as an adsorbent. The influence of operating parameters as contact time, temperature and adsorbent dose (0,2 - 2g/l) on the removal efficiency of Chemical oxygen demand, COD, and turbidity was analyzed. The bilge wastewater used for this study was supplied by Harbour Bouharoune. Chemical oxygen demand removal increased from 26.7% to 68.7% as the adsorbent dose increased from 0.2 to 2 g. The kinetics of adsorption by eggshells were fast, reaching 55 % of the total adsorption capacity in ten minutes (T= 20°C, pH =7.66, m=2g/L). It was found that the turbidity removal efficiency decreased and 95% were achieved at the end of 90 min reaction. The adsorption process was found to be effective for the purification of bilge water and pseudo-second-order kinetic model was fitted for COD removal.

Keywords: adsorption, bilge water, eggshells and kinetics, equilibrium and kinetics

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1206 A Prospective Audit to Look into Antimicrobial Prescribing in the Clinical Setting: In a Teaching Hospital in the UK

Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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1205 Introduction of a Standardised Proforma to Optimise Post-Operative Analgesia after Caesarean Section

Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

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Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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1204 Breastfeeding Knowledge, Attitudes and Practice: A Cross-Sectional Study among a Sample of Tunisian Mothers

Authors: Arfaoui Emna, Nouira Mariem

Abstract:

Background and aims: Breastfeeding is the reference feeding for a child, especially during the first months of life. It is not widespread in many countries due to many factors. There has been a decline in exclusive breastfeeding (EB) practice, particularly in the middle- and low-income countries, i.e., Tunisia. The aim of our study was to describe the knowledge, attitudes, and practice of a sample of Tunisian mothers toward breastfeeding. Methods: It was a descriptive cross-sectional study conducted during the year 2022 over a period of two months in three health structures in the north of Tunisia among mothers of infants aged 2 to 18 months. Levels of mothers’ knowledge (low/moderate/high) were determined using a score ranging from 0 to 11 points. EB was defined as the proportion of infants who were exclusively breastfed during the first six months of life. Results: A total of 180 women with a mean age of 33±4.9 years were included. The average knowledge score was equal to 6.4 ±1.5 points, with extremes ranging from 3 to 11 points. Most of the respondents had a moderate knowledge level (44.4%). More than half of surveyed mothers (66.1%) thought that breastfeeding deforms breasts, and 16.7% thought that breastfeeding is specific to women who do not work. Breastfeeding experience during the first week of life was considered difficult in 70% of cases. The prevalence of EB up to 6 months of age was equal to 16.4% [10.8-23.2]. The main reported obstacles during breastfeeding practice were having an insufficient quantity of breast milk (18.3%) and child difficulties with sucking (12.8%), and having pain in the breast while breastfeeding (12.80%). Conclusion: Our results highlighted the insufficient level of knowledge and a low prevalence of EB in our study population. Improving mothers’ knowledge and promoting EB practice is needed. Implementing health education strategies involving healthcare workers, who represent a main actor in education and breastfeeding promotion, is very important to reach a satisfactory frequency for EB.

Keywords: breastfeeding, practices, knowledge, Tunisia

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1203 Genetic Determinants of Ovarian Response to Gonadotropin Stimulation in Women Undergoing Assisted Reproductive Treatment

Authors: D. Tohlob, E. Abo Hashem, N. Ghareeb, M. Ghanem, R. Elfarahaty, S. A. Roberts, P. Pemberton, L. Mohiyiddeen, W. G. Newman

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Gonadotropin stimulation is used in females undergoing assisted reproductive treatment for ovulation induction, but ovarian response is variable and unpredictable in these women. More effective protocols and individualization of treatment are needed to increase the success rate of IVF/ICSI cycles. We genotyped seven variants reported in previous studies to be associated with ovarian response (number of ova retrieved and total gonadotropin dose) in women undergoing IVF treatment including FSHR variants Asn 680 Ser (c.2039 A > G), Thr 307 Ala (c. 919 > A), -29 G > A, HRG c.610 C > T gene, BMP15 -9 C > G, AMH Ile 49 Ser (c.146 G > T), and AMHR -489A˃G in 118 Egyptian females attending Mansoura Integrated Fertility Center in Egypt, these females were undergoing their first cycle of controlled ovarian hyper stimulation for IVF/ICSI treatment. They were analyzed by TaqMan allelic discrimination assay in Manchester Center of Genomic Medicine. We found no evidence of any significant difference (p value < 0.05) in the number of eggs retrieved or the gonadotropin dose used between individuals in all genotypes except for HRG c.610 C > T gene polymorphism where regression analysis gives a p value of 0.04 with a fewer eggs number in TT genotyped females. These results indicate that these variants do not provide sufficient clinically relevant data to individualize the treatment protocols.

Keywords: controlled ovarian hyperstimulation, gene variants, ovarian response, assisted reproduction

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1202 Breast Cancer Metastasis Detection and Localization through Transfer-Learning Convolutional Neural Network Classification Based on Convolutional Denoising Autoencoder Stack

Authors: Varun Agarwal

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Introduction: With the advent of personalized medicine, histopathological review of whole slide images (WSIs) for cancer diagnosis presents an exceedingly time-consuming, complex task. Specifically, detecting metastatic regions in WSIs of sentinel lymph node biopsies necessitates a full-scanned, holistic evaluation of the image. Thus, digital pathology, low-level image manipulation algorithms, and machine learning provide significant advancements in improving the efficiency and accuracy of WSI analysis. Using Camelyon16 data, this paper proposes a deep learning pipeline to automate and ameliorate breast cancer metastasis localization and WSI classification. Methodology: The model broadly follows five stages -region of interest detection, WSI partitioning into image tiles, convolutional neural network (CNN) image-segment classifications, probabilistic mapping of tumor localizations, and further processing for whole WSI classification. Transfer learning is applied to the task, with the implementation of Inception-ResNetV2 - an effective CNN classifier that uses residual connections to enhance feature representation, adding convolved outputs in the inception unit to the proceeding input data. Moreover, in order to augment the performance of the transfer learning CNN, a stack of convolutional denoising autoencoders (CDAE) is applied to produce embeddings that enrich image representation. Through a saliency-detection algorithm, visual training segments are generated, which are then processed through a denoising autoencoder -primarily consisting of convolutional, leaky rectified linear unit, and batch normalization layers- and subsequently a contrast-normalization function. A spatial pyramid pooling algorithm extracts the key features from the processed image, creating a viable feature map for the CNN that minimizes spatial resolution and noise. Results and Conclusion: The simplified and effective architecture of the fine-tuned transfer learning Inception-ResNetV2 network enhanced with the CDAE stack yields state of the art performance in WSI classification and tumor localization, achieving AUC scores of 0.947 and 0.753, respectively. The convolutional feature retention and compilation with the residual connections to inception units synergized with the input denoising algorithm enable the pipeline to serve as an effective, efficient tool in the histopathological review of WSIs.

Keywords: breast cancer, convolutional neural networks, metastasis mapping, whole slide images

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1201 X-Ray Detector Technology Optimization In CT Imaging

Authors: Aziz Ikhlef

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Most of multi-slices CT scanners are built with detectors composed of scintillator - photodiodes arrays. The photodiodes arrays are mainly based on front-illuminated technology for detectors under 64 slices and on back-illuminated photodiode for systems of 64 slices or more. The designs based on back-illuminated photodiodes were being investigated for CT machines to overcome the challenge of the higher number of runs and connection required in front-illuminated diodes. In backlit diodes, the electronic noise has already been improved because of the reduction of the load capacitance due to the routing reduction. This translated by a better image quality in low signal application, improving low dose imaging in large patient population. With the fast development of multi-detector-rows CT (MDCT) scanners and the increasing number of examinations, the clinical community has raised significant concerns on radiation dose received by the patient in both medical and regulatory community. In order to reduce individual exposure and in response to the recommendations of the International Commission on Radiological Protection (ICRP) which suggests that all exposures should be kept as low as reasonably achievable (ALARA), every manufacturer is trying to implement strategies and solutions to optimize dose efficiency and image quality based on x-ray emission and scanning parameters. The added demands on the CT detector performance also comes from the increased utilization of spectral CT or dual-energy CT in which projection data of two different tube potentials are collected. One of the approaches utilizes a technology called fast-kVp switching in which the tube voltage is switched between 80kVp and 140kVp in fraction of a millisecond. To reduce the cross-contamination of signals, the scintillator based detector temporal response has to be extremely fast to minimize the residual signal from previous samples. In addition, this paper will present an overview of detector technologies and image chain improvement which have been investigated in the last few years to improve the signal-noise ratio and the dose efficiency CT scanners in regular examinations and in energy discrimination techniques. Several parameters of the image chain in general and in the detector technology contribute in the optimization of the final image quality. We will go through the properties of the post-patient collimation to improve the scatter-to-primary ratio, the scintillator material properties such as light output, afterglow, primary speed, crosstalk to improve the spectral imaging, the photodiode design characteristics and the data acquisition system (DAS) to optimize for crosstalk, noise and temporal/spatial resolution.

Keywords: computed tomography, X-ray detector, medical imaging, image quality, artifacts

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1200 Comparison Between Bispectral Index Guided Anesthesia and Standard Anesthesia Care in Middle Age Adult Patients Undergoing Modified Radical Mastectomy

Authors: Itee Chowdhury, Shikha Modi

Abstract:

Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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1199 A Fuzzy Inference Tool for Assessing Cancer Risk from Radiation Exposure

Authors: Bouharati Lokman, Bouharati Imen, Bouharati Khaoula, Bouharati Oussama, Bouharati Saddek

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Ionizing radiation exposure is an established cancer risk factor. Compared to other common environmental carcinogens, it is relatively easy to determine organ-specific radiation dose and, as a result, radiation dose-response relationships tend to be highly quantified. Nevertheless, there can be considerable uncertainty about questions of radiation-related cancer risk as they apply to risk protection and public policy, and the interpretations of interested parties can differ from one person to another. Examples of tools used in the analysis of the risk of developing cancer due to radiation are characterized by uncertainty. These uncertainties are related to the history of exposure and different assumptions involved in the calculation. We believe that the results of statistical calculations are characterized by uncertainty and imprecision. Having regard to the physiological variation from one person to another. In this study, we develop a tool based on fuzzy logic inference. As fuzzy logic deals with imprecise and uncertain, its application in this area is adequate. We propose a fuzzy system with three input variables (age, sex and body attainable cancer). The output variable expresses the risk of infringement rate of each organ. A base rule is established from recorded actual data. After successful simulation, this will instantly predict the risk of infringement rate of each body following chronic exposure to 0.1 Gy.

Keywords: radiation exposure, cancer, modeling, fuzzy logic

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