Search results for: extracorporeal blood treatment

Authors: Boukhatem Mohamed Nadjib, Ferhat Mohamed Amine

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Essential Oils (EO) produced by medicinal plants have been traditionally used for respiratory tract infections and are used nowadays as ethical medicines for colds. The aim of this study was to test the efficacy of the Algerian EGEO against some respiratory tract pathogens by disc diffusion and vapour diffusion methods at different concentrations. The chemical composition of the EGEO was analysed by Gas Chromatography-Mass Spectrometry. Fresh leaves of E. globulus on steam distillation yielded 0.96% (v/w) of essential oil whereas the analysis resulted in the identification of a total of 11 constituents, 1.8 cineole (85.8%), α-pinene (7.2%) and β-myrcene (1.5%) being the main components. By disc diffusion method, EGEO showed potent antimicrobial activity against Gram-positive more than Gram-negative bacteria. The Diameter of Inhibition Zone (DIZ) varied from 69 mm to 75 mm for Staphylococcus aureus and Bacillus subtilis (Gram +) and from 13 to 42 mm for Enterobacter sp and Escherichia coli (Gram-), respectively. However, the results obtained by both agar diffusion and vapour diffusion methods were different. Significantly higher antibacterial activity was observed in the vapour phase at lower concentrations. A. baumanii and Klebsiella pneumoniae were the most susceptible strains to the oil vapour with DIZ varied from 38 to 42 mm. Therefore, smaller doses of EO in the vapour phase can be inhibitory to pathogenic bacteria. Else, the DIZ increased with increase in the concentration of the oil. There is growing evidence that EGEO in the vapour phase are effective antibacterial systems and appears worthy to be considered for practical uses in the treatment or prevention of patients with respiratory tract infections or as air decontaminants in the hospital. The present study indicates that EGEO has considerable antimicrobial activity, deserving further investigation for clinical applications.

Keywords: eucalyptus globulus, essential oils, respiratory tract pathogens, antimicrobial activity, vapour phase

Procedia PDF Downloads 367

Authors: Jefferson Camacho Mejia, Jenny Paola Forero Pachon, Luis Carlos Gomez Florez

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The innumerable possibilities offered by the use of Information Technology (IT) in the development of different socio-economic activities has made a change in the social paradigm and the emergence of the so-called information and knowledge society. The Colombian government, aware of this reality, has been promoting the use of IT as part of the E-government strategy adopted in the country. However, it is well known that the use of IT implies the existence of certain threats that put the security of information in the digital environment at risk. One of the priorities of the Colombian government is to improve access to alternative justice through IT, in particular, access to Alternative Dispute Resolution (ADR): conciliation, arbitration and friendly composition; by means of which it is sought that the citizens directly resolve their differences. To this end, a trend has been identified in the use of Online Dispute Resolution (ODR) systems, which extend the benefits of ADR to the digital environment through the use of IT. This article presents a process for the analysis of information security risks associated with the incorporation of ODR systems in the context of conciliation in Colombia, based on four fundamental stages identified in the literature: (I) Identification of assets, (II) Identification of threats and vulnerabilities (III) Estimation of the impact and 4) Estimation of risk levels. The methodological design adopted for this research was the grounded theory, since it involves interactions that are applied to a specific context and from the perspective of diverse participants. As a result of this investigation, the activities to be followed are defined to carry out an analysis of information security risks, in the context of the conciliation in Colombia supported by ODR systems, thus contributing to the estimation of the risks to make possible its subsequent treatment.

Keywords: alternative dispute resolution, conciliation, information security, online dispute resolution systems, process, risk analysis

Procedia PDF Downloads 238

Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

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Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

Procedia PDF Downloads 203

Authors: Prangya Ranjan Rout, Rajesh Roshan Dash, Puspendu Bhunia

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With the aim of enhancing the nutrient (ammonium and phosphate) removal from eutrophic wastewater with reduced cost, a novel media based multistage bio filter with drop aeration facility was developed in this work. The bio filter was packed with a discarded sponge iron industry by product, ‘dolochar’ primarily to remove phosphate via physicochemical approach. In the multi stage bio-filter drop, aeration was achieved by the process of percolation of the gravity-fed wastewater through the filter media and dropping down of wastewater from stage to stage. Ammonium present in wastewater got adsorbed by the filter media and biomass grown on the filter media and subsequently, got converted to nitrate through biological nitrification in the aerobic condition, as realized by drop aeration. The performance of the bio-filter in treating real eutrophic wastewater was monitored for a period of about 2 months. The influent phosphate concentration was in the range of 16-19 mg/L, and ammonium concentration was in the range of 65-78 mg/L. The average nutrient removal efficiency observed during the study period were 95.2% for phosphate and 88.7% for ammonium, with mean final effluent concentration of 0.91, and 8.74 mg/L, respectively. Furthermore, the subsequent release of nutrient from the saturated filter media, after completion of treatment process has been undertaken in this study and thin layer funnel analytical test results reveal the slow nutrient release nature of spent dolochar, thereby, recommending its potential agricultural application. Thus, the bio-filter displays immense prospective for treating real eutrophic wastewater, significantly decreasing the level of nutrients and keeping the effluent nutrient concentrations at par with the permissible limit and more importantly, facilitating the conversion of the waste materials into usable ones.

Keywords: ammonium removal, phosphate removal, multi-stage bio-filter, dolochar

Procedia PDF Downloads 193

Authors: Anindita Sen

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Oral fluid is a promising diagnostic matrix for drugs of abuse compared to urine and serum. Detection of methamphetamine in oral fluid would pave way for the easy evaluation of impairment in drivers during roadside drug testing as well as ensure safe working environments by facilitating evaluation of impairment in employees at workplaces. A membrane-based point-of-care (POC) friendly pre-treatment technique has been developed which aided elimination of interferences caused by salivary proteins and facilitated the demonstration of methamphetamine detection in saliva using a gold nanoparticle based colorimetric aptasensor platform. It was found that the colorimetric response in saliva was always suppressed owing to the matrix effects. By navigating the challenging interfering issues in saliva, we were successfully able to detect methamphetamine at nanomolar levels in saliva offering immense promise for the translation of these platforms for on-site diagnostic systems. This subsequently motivated the development of a handheld portable light meter device that can reliably transduce the aptasensors colorimetric response into absorbance, facilitating quantitative detection of analyte concentrations on-site. This is crucial due to the prevalent unreliability and sensitivity problems of the conventional drug testing kits. The fabricated light meter device response was validated against a standard UV-Vis spectrometer to confirm reliability. The portable and cost-effective handheld detector device features sensitivity comparable to the well-established UV-Vis benchtop instrument and the easy-to-use device could potentially serve as a prototype for a commercial device in the future.

Keywords: aptasensors, colorimetric gold nanoparticle assay, point-of-care, oral fluid

Procedia PDF Downloads 57

Authors: Torsten Schwan, Rene Unger

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Simulation of thermal and electrical building performance more and more becomes part of an integrative planning process. Increasing requirements on energy efficiency, the integration of volatile renewable energy, smart control and storage management often cause tremendous challenges for building engineers and architects. This mainly affects commercial or non-residential buildings. Their energy consumption characteristics significantly distinguish from residential ones. This work focuses on the many-objective optimization problem indoor air quality and comfort, especially in non-residential buildings. Based on a brief description of intermediate dependencies between different requirements on indoor air treatment it extends existing Modelica-based building physics models with additional system states to adequately represent indoor air conditions. Interfaces to corresponding HVAC (heating, ventilation, and air conditioning) system and control models enable closed-loop analyzes of occupants' requirements and energy efficiency as well as profitableness aspects. A complex application scenario of a nearly-zero-energy school building shows advantages of presented evaluation process for engineers and architects. This way, clear identification of air quality requirements in individual rooms together with realistic model-based description of occupants' behavior helps to optimize HVAC system already in early design stages. Building planning processes can be highly improved and accelerated by increasing integration of advanced simulation methods. Those methods mainly provide suitable answers on engineers' and architects' questions regarding more exuberant and complex variety of suitable energy supply solutions.

Keywords: indoor air quality, dynamic simulation, energy efficient control, non-residential buildings

Procedia PDF Downloads 231

Authors: Emily Hamilton, Adiel Kahana, Ron Hauser, Shimi Barda

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BACKGROUND: In the male fertility and sperm bank unit of Tel Aviv Sourasky medical center, women are treated with intrauterine insemination (IUI) using washed sperm from their partner or thawed sperm from a selected donor. In most cases, the women perform the IUI treatment in Sourasky, but sometimes they ask to undergo the insemination procedure in another clinic with their own fertility doctor. In these cases, the sperm sample is prepared at the Sourasky lab and the patient is inseminated after arriving to her doctor. Our laboratory has previously found that time negatively affects several parameters of thawed sperm, and we estimate that it has more severe and significant effect than on washed sperm. AIM: To examine the effect of time on the quality of washed sperm versus thawed sperm. METHODS: Sperm samples were collected from men referred for semen analysis. Each ejaculate was allowed to liquefy for at least 20 min at 37°C and analyzed for sperm motility and vitality percentage and DNA fragmentation index (Time 0). Subsequently, 1ml of the sample was divided into two parts, 1st part was washed only and the 2nd part was washed, frozen and thawed. Time 1 analysis occurred immediately after sperm washing or thawing. Time 2 analysis occurred 75 minutes after time 1. Statistical analysis was performed using Student t-test. P values<0.05 were considered significant. RESULTS: Preliminary data showed that time had a greater impact on the average percentages of sperm motility and vitality in thawed compared to washed sperm samples (26%±10% vs. 21%±10% and 21%±9% vs. 9%±10%, respectively). An additional trend towards increased average DNA fragmentation percentage in thawed samples compared to washed samples was observed (46%±18% vs. 25%±24%). CONCLUSION: Time negatively effects sperm quality. The effect is greater in thawed samples compared to fresh samples.

Keywords: ART, male fertility, sperm cryopreservation, sperm quality

Procedia PDF Downloads 192

Authors: Rania Hanafi Said, Rasha Mohamed Taha

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

Keywords: Immunohistochemistry, Nanochitosan, porphyromonas gingivitis, Tetracycline

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Authors: P. Leo, E. Cerri, L. Fratini, G. Buffa

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The Friction Stir Welding process uses an inert rotating mandrel and a force on the mandrel normal to the plane of the sheets to generate the frictional heat. The heat and the stirring action of the mandrel create a bond between the two sheets without melting the base metal. As matter of fact, the use of a solid state welding process limits the insurgence of defects, due to the presence of gas in melting bath, and avoids the negative effects of materials metallurgical transformation strictly connected with the change of phase. The industrial importance of Ti-6Al-4V alloy is well known. It provides an exceptional good balance of strength, ductility, fatigue and fracture properties together with good corrosion resistance and good metallurgical stability. In this paper, the authors analyze the microstructure of friction stir welded joints of Ti-6Al-4V processed at the same travel speed (35 mm/min) but at different rotation speeds (300-500 rpm). The microstructure of base material (BM), as result from both optical microscope and scanning electron microscope analysis is not homogenous. It is characterized by distorted α/β lamellar microstructure together with smashed zone of fragmented β layer and β retained grain boundary phase. The BM has been welded in the-as received state, without any previous heat treatment. Even the microstructure of the transverse and longitudinal sections of joints is not homogeneous. Close to the top of weld cross sections a much finer microstructure than the initial condition has been observed, while in the center of the joints the microstructure is less refined. Along longitudinal sections, the microstructure is characterized by equiaxed grains and lamellae. Both the length and area fraction of lamellas increases with distance from longitudinal axis. The hardness of joints is higher than that of BM. As the process temperature increases the average microhardness slightly decreases.

Keywords: friction stir welding, microhardness, microstructure, Ti-6Al-4V

Procedia PDF Downloads 379

Authors: Ashwinder K. Dhaliwal, G. P. S. Dhillon

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Eucalyptus is one of the most important forest tree species that can tolerate and grow well on degraded and unfertile soils which are not suitable for other tree species. Besides this, these trees have a short rotation and good economic value. However, the gall inducing wasp Leptocybe invasa Fisher and La Salle has been reported from many countries throughout the world. The spread of L. invasa is of huge economic concern as more than 20,000 ha of young Eucalyptus trees have already been affected in southern states of India. The host plant resistance being the first line of defense against insect pests demands the screening of different germplasm source against L. invasa. Keeping this in view, fourteen different clones of Eucalyptus spp. were evaluated for their susceptibility to L. invasa from a replicated clonal trial planted at Punjab Agricultural University, Ludhiana. The degree of gall infestation was recorded from three plants of each clone in each replication. Three branches selected from the lower, middle and upper canopy of the trees were selected for recording the total number of galls induced by L. invasa. The statistical analysis was done as per the procedure laid down for completely randomised block design (CRBD), analysis of variance (ANOVA), critical difference (CD) and variance components using Proc GLM (SAS software 9.3, SAS Institute Ltd. U.S.A). All possible treatment means were compared with Duncan’s multiple range test (DMRT) at 1 % probability level. The results showed that the clones C-9, C-45 and C-42 were completely free from the infestation of L. invasa. However, there was minor infestation of L. invasa on C-2135, C-413, C-407, C-35, C-72 and C-37 clones. The clone C-6 was severely infested by L. invasa followed by C-11, C-12, F-316 and C-25 clones. The information generated by this study will be helpful for future breeding and use in afforestation programmes.

Keywords: eucalyptus clones, gall wasp, Leptocybe invasa, screening, susceptibility

Procedia PDF Downloads 220

Authors: Elsa Makue Nguuffo, Esther Del Florence Moni Ndedi, Jacky Njiki Bikoï, Jean Paul Assam Assam, Maximilienne Ascension Nyegue

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Aims: The present study aims to evaluate the kinetic parameters of essential oils (EOs) and combinations fromDrypetes gossweileri Stem Bark, Ocimum gratissimum leaves, Cymbopogon citratusleaves after evaluation of their antibacterial activityonmultidrug-resistant strains ofShigella. Material and Methods:fiveclinical strains of Shigellaisolated from patients with diarrhoeaincluding Shigella flexneri, and 4 otherstrains of Shigella sppwere selected. Their antibiotic profile was established using agar test diffusion with seven antibiotics belonging to seven classes.EOs were extracted from each plant using hydrodistillation process. The activity of Ciprofloxacin®, OEs, and their combination formulatedinthe followingratios(w/w/w): C1: 1/1/1; C2: 2/1/1; C3: 1/2/1, C4:1/1/2 was evaluated microdilution assay. The various interactions of OEs in the different combinations were determined then the OE and the most active combination were retained to determine their kinetic parameters on S. flexneri. Results: Antibiotic susceptibility tests revealed that most Shigella isolates (n = 4) were resistant to six antibiotics tested. Ciprofloxacin (40%), Nalidixic acid (60%), Tetracycline (80%), Amoxicillin (100%), Cefotaxime (80%), Erythromycin (100%), and Cotrimoxazole (80%) were the profiles found in the different strains of Shigella. About the antibacterial activity of OEs, Drypetes gossweileriOE and C2 combination had shown a higher Shigellicide property with a Minimal Inhibitory Concentration(MIC) respectivelyranging from 0.078 mg/mL to 0.312 mg/mL and 0.012 to 1.562 mg/mL. Combinations of OEs showed various interactions whose synergistic effects were mostly encountered. The best deactivation was obtained by the combination C2 at 16 MIC withb= 1.962. Conclusion: the susceptibility of Shigella to OEs and their combinations justifies their use in traditional medicine in the treatment of shigellosis.

Keywords: shigella, multidrug-resistant, EOs, kinetic

Procedia PDF Downloads 98

Authors: A. A. Bajad, B. P. Sharma, Y. C. Gupta, B. S. Dilt, R. K. Gupta

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The present investigations were carried out at the experimental farm of Department of Floriculture and Landscape Architecture, Dr. Y. S. Parmar University of Horticulture and Forestry, Nauni, Solan, H.P. during 2015 and 2016. The experiment was laid out in a Randomized Block Design (factorial) consisting of 48 treatment combinations of four planting dates viz., D1- mid March, D2-mid April, D3-mid May and D4- mid June and two cultivars namely V1- Kamini and V2 -Poornima with six mulching materials M¬0¬- without mulch, M1- Black plastic mulch (100 µ), M2- Silver plastic mulch (100 µ), M3¬- Transparent plastic mulch (100 µ), M3-Transparent plastic mulch (100 µ), M4¬- Pine needle (100 µ) and M5- Grass (1 inch layer). Among different planting times, D4 i.e. mid June planting obtained best results for number of seed per flower (179.38), germination percent (83.92 %), electrical conductivity (0.97 ds/m), seedling length (7.93 cm), seedling dry weight (7.09 mg), seedling vigour index I (763.79), moisture content (7.83 %) and 1000 seed weight (1.94 g). However, seed yield per plant (14.30 g) was recorded to be maximum in mid of March. Among the cultivars, cv. ‘Poornima’ gave best results for number of seed per plant (187.30). However, cv. ‘Kamini’ recorded the best result for seed yield per plant (12.55), electrical conductivity (1.11 ds/m), germination percent (80.47 %), seedling length (6.39 cm), seedling dry weight (5.11 mg), seedling vigour index I (649.49), moisture content (9.28 %) and 1000 seed weight (1.70 g). Silver plastic obtained best results for number of seed per flower (170.10), seed yield per plant (15.66 g), germination percent (80.17 %), electrical conductivity (1.26 ds/m), seedling length (5.88 cm), seedling dry weight (4.46 mg), seedling vigour index I (616.78), Moisture content (9.35 %) and 100 seed weight (1.97 g).

Keywords: cultivars, mulch materials, planting times, flowers

Procedia PDF Downloads 284

Authors: A. Sathish, N. N. Lingaraju, K. N. Geetha, C. A. Srinivasamurthy, S. Bhaskar

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Under dryland conditions, it is observed that the soil organic matter is low due to low organic carbon content due to poor management with less use of inputs. On the other hand, disposal of sugar industry waste, i.e., spentwash is a major concern with limited space for land based treatment and disposal which causes environmental pollution. Spentwash is also a resource that can be applied for productive uses since it contains nutrients that have the potential for use in agriculture. The disposal of spent wash may lead to environmental pollution. Hence as an alternative mechanism, it was applied once to dry lands, and the experiments were conducted from 2012-13 to 2016-17 in kharif season in Maddur Taluk, Mandya District, Karnataka State, India. The study conducted was in 93 different farmers field (maize-11, finger millet-80 & horsegram-14). Spentwash was applied at the rate of 100 m³ ha⁻¹ before sowing of the crops. The results showed that yield of dryland crops like finger millet, horse gram and maize was recorded 14.75 q ha⁻¹, 6 q ha⁻¹ and 31.00 q ha⁻¹, respectively and the yield increase to an extent of 10-25 per cent with one time application of spentwash to dry lands compared to farmers practice, i.e., chemical fertilizer application. The higher yield may be attributed to slow and steady release of nutrients by spentwash throughout the crop growth period. In addition, the growth promoting and other beneficial substances present in spentwash might have also helped in better plant growth and yield. The soil sample analysis after harvest of the crops indicate acidic to neutral pH, EC of 0.11 dSm⁻¹ and Na of 0.20 C mol (P⁺) kg⁻¹ in the normal range which are not harmful. Hence, it can be applied to drylands at least once in 3 years which enhances yield as well as reduces environmental pollution.

Keywords: dryland crops, pollution, sugar industry waste, spentwash

Procedia PDF Downloads 237

Authors: Yolla Miranda, Marini Altyra, Karina Kalmapuspita Imas

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Oily sludge wastes always fill in upstream and downstream petroleum industry process. Sludge still contains oil that can use for energy storage. Recycling sludge is a method to handling it for reduce the toxicity and very probable to get the remaining oil around 20% from its volume. Froth flotation, a common method based on chemical unit for separate fine solid particles from an aqueous suspension. The basic composition of froth flotation is the capture of oil droplets or small solids by air bubbles in an aqueous slurry, followed by their levitation and collection in a froth layer. This method has been known as no intensive energy requirement and easy to apply. But the low efficiency and unable treat the high viscosity become the biggest problem in froth flotation unit. This study give the design to manage the high viscosity of sludge first and then entering the froth flotation including cavitation tube on it to change the bubbles into nano particles. The recovery in flotation starts with the collision and adhesion of hydrophobic particles to the air bubbles followed by transportation of the hydrophobic particle-bubble aggregate from the collection zone to the froth zone, drainage and enrichment of the froth, and finally by its overflow removal from the cell top. The effective particle separation by froth flotation relies on the efficient capture of hydrophobic particles by air bubbles in three steps. The important step is collision. Decreasing the bubble particles will increasing the collision effect. It cause the process more efficient. The pre-treatment, froth flotation, and cavitation tube integrated each other. The design shows the integrated unit and its process.

Keywords: sludge oil recovery, froth flotation, cavitation tube, nanobubbles, high viscosity

Procedia PDF Downloads 377

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

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

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

Procedia PDF Downloads 121

Authors: Howaida I. Abd-Alla, Amal Z. Hassan, Maha Soltan, Atef G. Hanna, Mounir M. El-Safty

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Acokanthera oblongifolia (Apocynaceae) is used for treatment of several infection diseases and is a well-known cardiac glycoside-containing plant. The infusion of their leaves is gargled to treat tonsillitis and is used medicinally to treat snakebites. The total cardiac glycosides content in the leaves was determined by referring to gitoxigenin as a reference compound. Two triterpenes, lup-20(29)-en-3β-ol (1) and oleanolic acid (2); two cardenolides, acovenoside A (3) and acobioside A (4) were isolated from the ethyl acetate extract. Their structures were determined on the basis of spectral analysis. Major constituents isolated from this species were evaluated for cytotoxicity against normal lung cell line (Wi38) and antimicrobial activities against Gram-positive (two strains) and Gram-negative bacteria (four strains), yeast-like fungi (two strains) and fungi (five strains). The minimum inhibitory concentration (MIC) of the compounds was determined using broth microdilution method. Their viral inhibitory effects against avian influenza virus type A (AI-H5N1) and Newcastle disease virus (NDV) in specific pathogen free (SPF) embryonated chicken eggs (ECE), chicken embryo fibroblasts (CEF) and Vero cells were evaluated. The cardenolide (3) showed viral inhibitory effects against AI-H5N1 and NDV in SPF ECE. The two cardenolides isolated have shown potent cytotoxicity against Vero cells. Compound (3) showed potent anti-Gram-negative bacteria activity. These results suggested that acovenoside A might be promising for future antiviral and antimicrobial drug design.

Keywords: Acokanthera, AI-H5N1, Cardenolides, NDV, SPF-ECE, VERO, Wi38 , Microbe

Procedia PDF Downloads 177

Authors: Sarpong Boateng, Rohit Balasundaram, Akua Afrah Amoah

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Introduction: Racial and Gender disparities have been found to be independently associated with Salivary Gland Cancers (SGCs) survival; however, to our best knowledge, there are no previous studies on the interplay of these social determinants on the prognosis of SGCs. The objective of this study was to examine the joint effect of race and gender on the survival of SGCs. Methods: We analyzed survival outcomes of 13,547 histologically confirmed cases of SGCs using the Surveillance Epidemiology and End Results (SEER) database (2004 to 2015). Multivariable Cox regression analysis and Kaplan-Meier curves were used to estimate hazard ratios (HR) after controlling for age, tumor characteristics, treatment type and year of diagnosis. Results: 73.5% of the participants were whites, 8.5% were blacks, 10.1% were Hispanics and 58.5% were males. Overall, males had poorer survival than females (HR = 1.16, p=0.003). In the adjusted multivariable model, there were no significant differences in survival by race. However, the interaction of gender and race was statistically significant (p=0.01) in Hispanic males. Thus, compared to White females (reference), Hispanic females had significantly better survival (HR=0.53), whiles Hispanic males had worse survival outcomes (HR=1.82) for SGCs. Conclusions: Our results show significant interactions between race and gender, with racial disparities varying across the different genders for SGCs survival. This study indicates that racial and gender differences are crucial factors to be considered in the prognostic counseling and management of patients with SGCs. Biologic factors, tumor genetic characteristics, chemotherapy, lifestyle, environmental exposures, and socioeconomic and dietary factors are potential yet proven reasons that could account for racial and gender differences in the survival of SGCs.

Keywords: salivary, cancer, survival, disparity, race, gender, SEER

Procedia PDF Downloads 199

Authors: Oksana G. Cherednichenko, Anastasia L. Pilyugina, Sergey N.Lukashenko, Elena G. Gubitskaya

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The estimation of accumulated radiation doses in people professionally exposed to ionizing radiation was performed using methods of biological (chromosomal aberrations frequency in lymphocytes) and physical (radionuclides analysis in urine, whole-body radiation meter, individual thermoluminescent dosimeters) dosimetry. A group of 84 "A" category employees after their work in the territory of former Semipalatinsk test site (Kazakhstan) was investigated. The dose rate in some funnels exceeds 40 μSv/h. After radionuclides determination in urine using radiochemical and WBC methods, it was shown that the total effective dose of personnel internal exposure did not exceed 0.2 mSv/year, while an acceptable dose limit for staff is 20 mSv/year. The range of external radiation doses measured with individual thermo-luminescent dosimeters was 0.3-1.406 µSv. The cytogenetic examination showed that chromosomal aberrations frequency in staff was 4.27±0.22%, which is significantly higher than at the people from non-polluting settlement Tausugur (0.87±0.1%) (р ≤ 0.01) and citizens of Almaty (1.6±0.12%) (р≤ 0.01). Chromosomal type aberrations accounted for 2.32±0.16%, 0.27±0.06% of which were dicentrics and centric rings. The cytogenetic analysis of different types group radiosensitivity among «professionals» (age, sex, ethnic group, epidemiological data) revealed no significant differences between the compared values. Using various techniques by frequency of dicentrics and centric rings, the average cumulative radiation dose for group was calculated, and that was 0.084-0.143 Gy. To perform comparative individual dosimetry using physical and biological methods of dose assessment, calibration curves (including own ones) and regression equations based on general frequency of chromosomal aberrations obtained after irradiation of blood samples by gamma-radiation with the dose rate of 0,1 Gy/min were used. Herewith, on the assumption of individual variation of chromosomal aberrations frequency (1–10%), the accumulated dose of radiation varied 0-0.3 Gy. The main problem in the interpretation of individual dosimetry results is reduced to different reaction of the objects to irradiation - radiosensitivity, which dictates the need of quantitative definition of this individual reaction and its consideration in the calculation of the received radiation dose. The entire examined contingent was assigned to a group based on the received dose and detected cytogenetic aberrations. Radiosensitive individuals, at the lowest received dose in a year, showed the highest frequency of chromosomal aberrations (5.72%). In opposite, radioresistant individuals showed the lowest frequency of chromosomal aberrations (2.8%). The cohort correlation according to the criterion of radio-sensitivity in our research was distributed as follows: radio-sensitive (26.2%) — medium radio-sensitivity (57.1%), radioresistant (16.7%). Herewith, the dispersion for radioresistant individuals is 2.3; for the group with medium radio-sensitivity — 3.3; and for radio-sensitive group — 9. These data indicate the highest variation of characteristic (reactions to radiation effect) in the group of radio-sensitive individuals. People with medium radio-sensitivity show significant long-term correlation (0.66; n=48, β ≥ 0.999) between the values of doses defined according to the results of cytogenetic analysis and dose of external radiation obtained with the help of thermoluminescent dosimeters. Mathematical models based on the type of violation of the radiation dose according to the professionals radiosensitivity level were offered.

Keywords: biodosimetry, chromosomal aberrations, ionizing radiation, radiosensitivity

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Authors: Sally Heyeon Hwang

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Within decision theory, there are normative principles that dictate how one should act in addition to empirical theories of actual behavior. As a normative guide to one’s actual behavior, evidential or causal decision-theoretic equations allow one to identify outcomes with maximal utility values. The choice that each person makes, however, will, of course, differ according to varying assignments of weight and probability values. Regarding these different choices, it remains a subject of considerable philosophical controversy whether individual subjects have the capacity to exercise free will with respect to the assignment of probabilities, or whether instead the assignment is in some way constrained. A version of this question is given a precise form in Richard Jeffrey’s assumption that free will is necessary for Newcomb’s paradox to count as a decision problem. This paper will argue, against Jeffrey, that decision theory does not require the assumption of libertarian freedom. One of the hallmarks of decision-making is its application across a wide variety of contexts; the implications of a background assumption of free will is similarly varied. One constant across the contexts of decision is that there are always at least two levels of choice for a given agent, depending on the degree of prior constraint. Within the context of Newcomb’s problem, when the predictor is attempting to guess the choice the agent will make, he or she is analyzing the determined aspects of the agent such as past characteristics, experiences, and knowledge. On the other hand, as David Lewis’ backtracking argument concerning the relationship between past and present events brings to light, there are similarly varied ways in which the past can actually be dependent on the present. One implication of this argument is that even in deterministic settings, an agent can have more free will than it may seem. This paper will thus argue against the view that a stable background assumption of free will or determinism in decision theory is necessary, arguing instead for a compatibilist decision theory yielding a novel treatment of Newcomb’s problem.

Keywords: decision theory, compatibilism, free will, Newcomb’s problem

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Authors: J. Raub, H. Schillok, L. Kaupe, C. Jung-Sievers, G. Pitschel-Walz, M. Bühner, J. Gensichen, F. D. Pokal-Gruppe

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Introduction: In Germany, depression ranks among the top ten diseases with the highest disease burden and often occurs with comorbidities. Collaborative Care (CC), a concept developed in the United States for the primary care management of chronic diseases, has been identified as an efficient model for the treatment of depression in general medicine. A recent meta-analysis highlights research gaps regarding CC in patients with psychiatric multimorbidity. The highest prevalence of psychiatric comorbidities in depression is observed in anxiety disorders, post-traumatic stress disorder (PTSD), and substance use disorders. Methods: We conducted a literature search following the PRISMA guidelines with three components: Collaborative Care, Depression and randomized controlled trial on the common databases. We focused on the examination of psychiatric comorbidities in depression, specifically Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD). Results: During the screening process, we identified nine relevant articles related to PTSD, the number of articles related to Substance Use Disorder (SUD) was ten. We examined a total of 8,634 individuals. Our literature review did not reveal any overall significant superiority of the Collaborative Care model compared to Usual Care in patients with depression with comorbid Substance Use Disorder (SUD) or Posttraumatic Stress Disorder (PTSD). Discussion: Five studies demonstrate a faster and statistically significant improvement in depression outcomes among patients with Substance Use Disorder (SUD) and Posttraumatic Stress Disorder (PTSD). Currently, several randomized controlled trials on the topic of Collaborative Care in depression with psychiatric comorbidity are ongoing, such as miCare, Claro and COMET.

Keywords: Depression, primary care, collaborative care, PTSD, Substance use Disorder

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Authors: Kyungae Jo, Eun Young Kim, Byungsoo Shin, Kwang Soon Shin, Hyung Joo Suh

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Gamma-aminobutyric acid (GABA) and 5-hydroxytryptophan (5-HTP) are amino acids of digested nutrients or food ingredients and these can possibly be utilized as non-pharmacologic treatment for sleep disorder. We previously investigated the GABA/5-HTP mixture is the principal concept of sleep-promoting and activity-repressing management in nervous system of D. melanogaster. Two experiments in this study were designed to evaluate sleep-promoting effect of GABA/5-HTP mixture, to clarify the possible ratio of sleep-promoting action in the Drosophila invertebrate model system. Behavioral assays were applied to investigate distance traveled, velocity, movement, mobility, turn angle, angular velocity and meander of two amino acids and GABA/5-HTP mixture with caffeine treated flies. In addition, differentially expressed gene (DEG) analyses from next generation sequencing (NGS) were applied to investigate the signaling pathway and functional interaction network of GABA/5-HTP mixture administration. GABA/5-HTP mixture resulted in significant differences between groups related to behavior (p < 0.01) and significantly induced locomotor activity in the awake model (p < 0.05). As a result of the sequencing, the molecular function of various genes has relationship with motor activity and biological regulation. These results showed that GABA/5-HTP mixture administration significantly involved the inhibition of motor behavior. In this regard, we successfully demonstrated that using a GABA/5-HTP mixture modulates locomotor activity to a greater extent than single administration of each amino acid, and that this modulation occurs via the neuronal system, neurotransmitter release cycle and transmission across chemical synapses.

Keywords: sleep, γ-aminobutyric acid, 5-hydroxytryptophan, Drosophila melanogaster

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Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail

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Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.

Keywords: sanitation, toilet, economic cost of health, water, Punjab

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Authors: D. S. Gomes, A. T. Silva

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Analysis of the uncertainty quantification related to nuclear safety margins applied to the nuclear reactor is an important concept to prevent future radioactive accidents. The nuclear fuel performance code may involve the tolerance level determined by traditional deterministic models producing acceptable results at burn cycles under 62 GWd/MTU. The behavior of nuclear fuel can simulate applying a series of material properties under irradiation and physics models to calculate the safety limits. In this study, theoretical predictions of nuclear fuel failure under transient conditions investigate extended radiation cycles at 75 GWd/MTU, considering the behavior of fuel rods in light-water reactors under reactivity accident conditions. The fuel pellet can melt due to the quick increase of reactivity during a transient. Large power excursions in the reactor are the subject of interest bringing to a treatment that is known as the Fuchs-Hansen model. The point kinetic neutron equations show similar characteristics of non-linear differential equations. In this investigation, the multivariate logistic regression is employed to a probabilistic forecast of fuel failure. A comparison of computational simulation and experimental results was acceptable. The experiments carried out use the pre-irradiated fuels rods subjected to a rapid energy pulse which exhibits the same behavior during a nuclear accident. The propagation of uncertainty utilizes the Wilk's formulation. The variables chosen as essential to failure prediction were the fuel burnup, the applied peak power, the pulse width, the oxidation layer thickness, and the cladding type.

Keywords: logistic regression, reactivity-initiated accident, safety margins, uncertainty propagation

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Authors: Yuan-Chung Tsai, Masao Kamimura, Kohei Soga, Hsin-Cheng Chiu

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In order to enhance the photodynamic/photothermal therapeutic efficacy on glioblastoma, the functionized upconversion nanoparticles with the capability of converting the deep tissue penetrating near-infrared light into visible wavelength for activating photochemical reaction were developed. The drug-loaded nanoparticles (NPs) were obtained from the self-assembly of oleic acid-coated upconversion nanoparticles along with maleimide-conjugated poly(ethylene glycol)-cholesterol (Mal-PEG-Chol), as the NP stabilizer, and hydrophobic photosensitizers, IR-780 (for photothermal therapy, PTT) and mTHPC (for photodynamic therapy, PDT), in aqueous phase. Both the IR-780 and mTHPC were loaded into the hydrophobic domains within NPs via hydrophobic association. The peptide targeting ligand, angiopep-2, was further conjugated with the maleimide groups at the end of PEG adducts on the NP surfaces, enabling the affinity coupling with the low-density lipoprotein receptor-related protein-1 of tumor endothelial cells and malignant astrocytes. The drug-loaded NPs with the size of ca 80 nm in diameter exhibit a good colloidal stability in physiological conditions. The in vitro data demonstrate the successful targeting delivery of drug-loaded NPs toward the ALTS1C1 cells (murine astrocytoma cells) and the pronounced cytotoxicity elicited by combinational effect of PDT and PTT. The in vivo results show the promising brain orthotopic tumor targeting of drug-loaded NPs and sound efficacy for brain tumor dual-modality treatment. This work shows great potential for improving photodynamic/photothermal therapeutic efficacy of brain cancer.

Keywords: drug delivery, orthotopic brain tumor, photodynamic/photothermal therapies, upconversion nanoparticles

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Authors: Pramod Kumar Sharma, Pratibha Kumari, Udai Pratap Singh, Sustainability

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In the Indo-Gangetic Plains of South-East Asia, the rice-wheat cropping system (RWCS) is dominant with conventional tillage (CT) without residue management, which shows depletion of soil fertility and non-sustainable crop productivity. Hence, this investigation was planned to identify suitable natural resource management practices involving different tillage and crop establishment (TCE) methods along with crop residue and their effects, on the sustainability of dominant cropping systems through enhancing soil fertility and productivity. This study was conducted for two consecutive years 2018-19 and 2019-20 on a long-term field experiment that was started in the year 2015-16 taking six different combinations of TCE methods viz. CT, partial conservation agriculture (PCA) i.e. anchored residue of rice and full conservation agriculture (FCA)] i.e. anchored residue of rice and wheat under RWCS in terms of crop productivity, sustainability of soil health, and crop nutrition by the crops. Results showed that zero tillage direct-seeded rice (ZTDSR) - zero tillage wheat (ZTW) [FCA + green gram residue retention (RR)] recorded the highest yield attributes and yield during both the crops. Compared to conventional tillage rice (CTR)-conventional tillage wheat (CTW) [residue removal (R 0 )], the soil quality parameters were improved significantly with ZTDSR-ZTW (FCA+RR). Overall, ZTDSR-ZTW (FCA+RR) had higher nutrient uptake by the crops than CT-based treatment CTR-CTW (R 0 ) and CTR-CTW (RI).These results showed that there is significant profitability of yield and resource utilization by the adoption of FCA it may be a better alternative to the dominant tillage system i.e. CT in RWSC.

Keywords: tillage and crop establishment, soil fertility, rice-wheat cropping system, sustainability

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Authors: Anna Słupik, Patryk Wąsowski, Anna Mosiołek, Dariusz Białoszewski

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Introduction: Kinesiology Taping is one of the most popular techniques used for treatment and supporting physiological processes in sports medicine and physiotherapy. Often it is used to sensorimotor skills of lower limbs by athletes. The aim of the study was to determine the effect of the application of muscle Kinesiology Taping to feel the position setting in motion the joint active. Material and methods: The study involved 50 healthy people between 18 and 30 years of age, 30 men and 20 women (mean age 23.24 years). The participants were divided into two groups. The study group was qualified for Kinesiology Taping application (muscle application, type Y, for quadriceps femoris muscle), while the remaining people used the application made of plaster (placebo group). Testing was performed prior to applying taping, with the applied application (after 30 minutes), then 24 hours after wearing, and after removing the tape. Each evaluated joint position sense - Error of Active Reproduction of Joint Position. Results: The survey revealed no significant differences in measurement between the study group and the placebo group (p> 0.05). No significant differences in time taking into account all four measurements in the group with the applied CT application, which was supported by pairs (p> 0.05). Also in the placebo group showed no significant differences over time (p> 0.05). There was no significant difference between the errors committed in the direction of flexion and extension. Conclusions: 1. Application muscle Kinesiology Taping had no significant effect on the knee joint proprioception. Its use in order to improve sensorimotor seems therefore unjustified. 2. There are no differences between applications Kinesiology Taping and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous and study group.

Keywords: joint position sense, kinesiology taping, knee joint, proprioception

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Authors: Nigar Sultanova

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Facial morphology is a constant topic of concern for clinicians. When anthropometric methods were introduced into clinical practice to quantify changes in the craniofacial framework, features distinguishing various ethnic group were discovered. Normative data of facial measurements are indispensable to precise determination of the degree of deviations from normal. Establish the reference range of facial proportions in Azerbaijan population by anthropometric measurements of craniofacial complex. The study group consisted of 350 healthy young subjects, 175 males and 175 females, 18 to 25 years of age, from 7 different regions of Azerbaijan. The anthropometric examination was performed according to L.Farkas's method with our modification. In order to determine the morphologic characteristics of seven regions of the craniofacial complex 42 anthropometric measurements were selected. The anthropometric examination. Included the usage of 33 anthropometric landmarks. The 80 indices of the facial proportions, suggested by Farkas and Munro, were calculated: head -10, face - 23, nose - 23, lips - 9, orbits - 11, ears - 4. The date base of the North American white population was used as a reference group. Anthropometric measurements of facial proportions in Azerbaijan population revealed a significant difference between mеn and womеn, according to sexual dimorphism. In comparison with North American whites, considerable differences of facial proportions were observed in the head, face, orbits, labio-oral, nose and ear region. However, in women of the Azerbaijani population, 29 out of 80 proportion indices were similar to the proportions of NAW women. In the men of the Azerbaijani population, 27 out of 80 proportion indices did not reveal a statistically significant difference from the proportions of NAW men. Estimation of the reference range of facial proportions in Azerbaijan population migth be helpful to formulate surgical plan in treatment of congenital or post-traumatic facial deformities successfully.

Keywords: facial morphology, anthropometry, indices of proportion, measurement

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Authors: Kalyani Mer

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Hydrogen peroxide (H₂O₂) is one of the most efficient and commonly used oxidants in in-situ chemical oxidation (ISCO) of organic contaminants. In the present study, we investigated the activation of H₂O₂ by heavy metal (nickel and lead metal ions) loaded biochar for phenol degradation in an aqueous solution (concentration = 100 mg/L). It was found that H₂O₂ can be effectively activated by biochar, which produces hydroxyl (•OH) radicals owing to an increase in the formation of persistent free radicals (PFRs) on biochar surface. Ultrasound treated (30s duration) biochar, chemically activated by 30% phosphoric acid and functionalized by diethanolamine (DEA) was used for the adsorption of heavy metal ions from aqueous solutions. It was found that modified biochar could remove almost 60% of nickel in eight hours; however, for lead, the removal efficiency reached up to 95% for the same time duration. The heavy metal loaded biochar was further used for the degradation of phenol in the absence and presence of H₂O₂ (20 mM), within 4 hours of reaction time. The removal efficiency values for phenol in the presence of H₂O₂ were 80.3% and 61.9%, respectively, by modified biochar loaded with nickel and lead metal ions. These results suggested that the biochar loaded with nickel exhibits a better removal capacity towards phenol than the lead loaded biochar when used in H₂O₂ based oxidation systems. Meanwhile, control experiments were set in the absence of any activating biochar, and the removal efficiency was found to be 19.1% when only H₂O₂ was added in the reaction solution. Overall, the proposed approach serves a dual purpose of using biochar for heavy metal ion removal and treatment of organic contaminants by further using the metal loaded biochar for H₂O₂ activation in ISCO processes.

Keywords: biochar, ultrasound, heavy metals, in-situ chemical oxidation, chemical activation

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Authors: R. Razavizadeh, F. Adabavazeh, M. Rezaee Chermahini

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Salinity is one of the most widespread agricultural problems in arid and semi-arid areas that limits the plant growth and crop productivity. In this study, the salt stress effects on protein, reducing sugar, proline contents and antioxidant enzymes activities of Carum copticum L. under in vitro conditions were studied. Seeds of C. copticum were cultured in Murashige and Skoog (MS) medium containing 0, 25, 50, 100 and 150 mM NaCl and calli were cultured in MS medium containing 1 μM 2, 4-dichlorophenoxyacetic acid, 4 μM benzyl amino purine and different levels of NaCl (0, 25, 50, 100 and 150 mM). After NaCl treatment for 28 days, the proline and reducing sugar contents of shoots, roots and calli increased significantly in relation to the severity of the salt stress. The highest amount of proline and carbohydrate were observed at 150 and 100 mM NaCl, respectively. The reducing sugar accumulation in shoots was the highest as compared to roots, whereas, proline contents did not show any significant difference in roots and shoots under salt stress. The results showed significant reduction of protein contents in seedlings and calli. Based on these results, proteins extracted from the shoots, roots and calli of C. copticum treated with 150 mM NaCl showed the lowest contents. The positive relationships were observed between activity of antioxidant enzymes and the increase in stress levels. Catalase, ascorbate peroxidase and superoxide dismutase activity increased significantly under salt concentrations in comparison to the control. These results suggest that the accumulation of proline and sugars, and activation of antioxidant enzymes play adaptive roles in the adaptation of seedlings and callus of C. copticum to saline conditions.

Keywords: antioxidant enzymes, Carum copticum, organic solutes, salt stress

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Authors: Tabassum Yasmin, Hamid Pahlevan

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HIV/Hepatitis C co-infection treatments have evolved substantially and they have similar sustained virologic response rates as those of Hepatitis C monoinfected population. There are a few studies on therapy of patients with dual genotypes, especially in HIV/Hepatic C coinfected group. Most studies portrayed case reports of dual genotype chronic Hepatitis C coinfection treatment with Sofosbuvir/Ledipasvir and Ribavirin. A 79-year-old male with a history of HIV on Truvada and Isentress had chronic Hepatitis C with 1a and 2 genotypes. The patient has a history of alcohol intake for 40 years but recently stopped drinking alcohol. He has a history of intravenous drug use in the past and currently is not using any recreational drugs. Patient has Fibro score of 0.7 with Metavir score F2 to F4. AFP is 3.2. The HCV RNA is 493,034 IU/ML. The HBV viral DNA is < 1.30 (not detected). The CD4 is 687CU/MM. The FIB 4 is 3.34 with APRI index 0.717. The HIV viral load is 101 copies/ML. MRI abdomen did not show any liver abnormality. Fixed dose Sofosbuvir/Ledipasvir was used for therapy without Ribavirin. He tolerated medication except for some minor gastrointestinal side effects like abdominal bloating. He demonstrated 100% adherence rate. Patient completed 12 weeks of therapy. HCV RNA was undetectable at 4 and 12 weeks. He achieved SVR at week 12 and subsequently had undetectable RNA for 2 years. Dual genotype prevalence in chronic hepatitis C population is rare, especially in HIV/hepatic coinfection. Our case demonstrates that dual genotypic cases can still be successfully treated with Direct Acting Antiviral agents. The newer agents for therapy for pan genotypes were not available at the time the patient was being treated. We demonstrated that dual agent therapy was still able to maintain SVR in our patient.

Keywords: HIV/Hepatitis C, SVR (sustained virologic response), DAA (direct active antiviral agents, dual genotype

Procedia PDF Downloads 195