Search results for: alternative medication

Authors: Svetlana V. Topolyanskaya, Tatyana A. Eliseeva, Olga N. Vakulenko, Leonid I. Dvoretski

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Introduction: Limited data are available on osteoporosis in centenarians. Therefore, we evaluated bone mineral density in long-living patients with coronary artery disease (CAD). Methods: 202 patients hospitalized with CAD were enrolled in this cross-sectional study. The patients' age ranged from 90 to 101 years. The majority of study participants (64.4%) were women. The main exclusion criteria were any disease or medication that can lead to secondary osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Normal lumbar spine BMD was observed in 40.9%, osteoporosis – in 26.9%, osteopenia – in 32.2% of patients. Normal proximal femur BMD values were observed in 21.3%, osteoporosis – in 39.9%, and osteopenia – in 38.8% of patients. Normal femoral neck BMD was registered only in 10.4% of patients, osteoporosis was observed in 60.4%, osteopenia in 29.2%. Significant positive correlation was found between all BMD values and body mass index of patients (p < 0.001). Positive correlation was registered between BMD values and serum uric acid (p=0.0005). The likelihood of normal BMD values with hyperuricemia increased 3.8 times, compared to patients with normal uric acid, who often have osteoporosis (Odds Ratio=3.84; p = 0.009). Positive correlation was registered between all BMD values and body mass index (p < 0.001). Positive correlation between triglycerides levels and T-score (p=0.02), but negative correlation between BMD and HDL-cholesterol (p=0.02) were revealed. Negative correlation between frailty severity and BMD values (p=0.01) was found. Positive correlation between BMD values and functional abilities of patients assessed using Barthel index (r=0,44; p=0,000002) and IADL scale (r=0,36; p=0,00008) was registered. Fractures in history were observed in 27.6% of patients. Conclusions: The study results indicate some features of BMD in long-livers. In the study group, significant relationships were found between bone mineral density on the one hand, and patients' functional abilities on the other. It is advisable to further study the state of bone tissue in long-livers involving a large sample of patients.

Keywords: osteoporosis, bone mineral density, centenarians, coronary artery disease

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Authors: Zahra R. Almansoor

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Background: Selective serotonin reuptake inhibitors (SSRI’s) and cognitive behavioural therapy (CBT) are the main treatment methods used for patients with obsessive compulsive disorder (OCD) under the National Institute of Health and Care Excellence (NICE) guidelines. Yet many patients are left with residual symptoms or remit, so several other therapeutic approaches have been explored. Objective: The objective was to systematically review the available literature regarding the treatment efficacy of current and potential approaches and diagnostic strategies. Method: First, studies were examined concerning diagnosis, prognosis, and influencing factors. Then, one reviewer conducted a systematic search of six databases using stringent search terms. Results of studies exploring the efficacy of treatment interventions were analysed and compared separately for adults and children. This review was limited to randomised controlled trials (RCT’s) conducted from 2016 onwards, and an improved Y-BOCS (Yale- Brown obsessive compulsive scale) score was the primary outcome measure. Results: Technology-based interventions including internet-based cognitive behavioural therapy (iCBT) were deemed as potentially effective. Discrepancy remains about the benefits of SSRI use past one year, but potential medication adjuncts include amantadine. Treatments such as association splitting and family and mindfulness strategies also have future potential. Conclusion: A range of potential therapies exist, either as treatment adjuncts to current interventions or as sole therapies. To further improve efficacy, it may be necessary to remodel the current NICE stepped-care model, especially regarding the potential use of lower intensity, cheaper treatments, including iCBT. Although many interventions show promise, further research is warranted to confirm this.

Keywords: family and group treatment, mindfulness strategies, novel treatment approaches, standard treatment, technology-based interventions

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Authors: Lucas Bernardes Naves, Luis Almeida

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The paper includes a review concerning the use of some composites including poly(lactide-co-glycolide) (PGLA), zeolite and Gadopentetic acid (Gd-DTPA) loaded chitosan nanoparticles (Gd-nanoCPs) in order to establish a new alternative for the treatment of Melanoma Skin Cancer. The main goal of this paper it to make a review of what scientist have done in the last few years, as well as to propose a less invasive therapy for skin cancer, by using Hydrocolloid, based on PLGA coated with Gd-nanoCPs for Neutron Capture Therapy.

Keywords: cancer therapy, dressing polymers, melanoma, wound healing

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Authors: Sangkhao M., Butcher B. A.

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Diazepam (known as valium) is a medication for calming effect. Many reports on committed suicide cases shown that diazepam is frequently used for this purpose. This research aims to study effect of diazepam on the development of forensically important blowflies, Chrysomya megacephala (Diptera: Calliphoridae) using micro-computed tomography (micro CT). In this study, four rabbits were treated with three different lethal doses of diazepam and one control (LD₀, LD₅₀, LD₁₀₀ and LC). The rabbit’s livers were removed for rearing the blowflies. Pupae were sampled for two series (ages; S1: 24h and S2: 120h) of development. After preparing the specimens, all samples were performed Micro CT using Skyscan 1172. The results shown the effect of diazepam on internal organs and tissues such as brain, cavity of the body, gas bubble, meconium and especially fat body. In the control group, in series 1 (LCS1), fat body was equally dispersed in the head, thorax, and abdomen, development of internal organs were not completed, however, brain, thoracic muscle, wings, legs and rectum were able to observe at 24h after developing into the pupal stage. Development of each organ in the control group in the series two was completed. In the treatment groups, LD₀, LD₅₀, LD₁₀₀ (Series 1 and Series 2), tissues are different, such as gas bubble in LD₀S1, was observed due to rapidity morphological changes during the metamorphosis of blowfly’s pupa in this treatment. Meconium was observed in LD₅₀S2 group because excretion of metabolic waste was not completed. All of the samples in the treatment groups had differentiation of fat bodies because metabolic activities were not completed and these changes affected on functions of every internal system. Discovering of differentiated fat bodies are important results because fat bodies of insect functions as liver in human, therefore it is shown that toxin eliminates from blowfly’s body and homeostatic maintenance of the hemolymph proteins, lipid and carbohydrates in each treatment group are abnormal.

Keywords: forensic toxicology, forensic entomology, diptera, diazepam

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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Authors: Peter David Reiss

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The concept of the psychosis prodrome has allowed for the identification of adolescent and young adult patients who have a significantly elevated risk of developing schizophrenia spectrum disorders. A number of different interventions have been tested in order to prevent or delay progression of symptoms. To date, there has been no consistent meta-analytical evidence to support efficacy of antipsychotic treatment for patients in the prodromal state, and their use remains therefore inconclusive. Although antipsychotics may manage symptoms transiently, they have not been found to prevent or delay onset of psychotic disorders. Furthermore, pharmacological intervention in high-risk individuals remains controversial, because of the antipsychotic side effect profile in a population in which only about 20 to 35 percent will eventually convert to psychosis over a two-year period, with even after two years conversion rates not exceeding 30 to 40 percent. This general estimate is additionally problematic, in that it ignores the fact that there is significant variation in individual risk among clinical high-risk cases. The current lack of reliable tests for at-risk patients makes it difficult to justify individual treatment decisions. Preventive treatment should ideally be dictated by an individual’s risk while minimizing potentially harmful medication exposure. This requires more accurate predictive assessments by using valid and accessible prognostic markers. The following will compare prediction and risk modification potential of behavioral biomarkers such as disturbances of basic sense of self and emotion awareness, neurocognitive biomarkers such as attention, working and declarative memory, and neurophysiological biomarkers such as glutamatergic abnormalities and NMDA receptor dysfunction. Identification of robust biomarkers could therefore not only provide more reliable means of psychosis prediction, but also help test and develop new clinical interventions targeted at the prodromal state.

Keywords: at-risk mental state, biomarkers, glutamatergic system, NMDA receptor, psychosis prodrome, schizophrenia

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Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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Authors: Afsaneh Soltani, Zahra Mohajer

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Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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Authors: Akhila Jose

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The cement industry is one of the major contributors to the global warming due to the release of greenhouse gases. The primary binder in conventional concrete is Ordinary Portland cement (OPC) and billions of tons are produced annually all over the world. An alternative binding material to OPC is needed to reduce the environmental impact caused during the cement manufacturing process. Geopolymer concrete is an ideal material to substitute cement-based binder. Geopolymer is an inorganic alumino-silicate polymer. Geopolymer Concrete (GPC) is formed by the polymerization of aluminates and silicates formed by the reaction of solid aluminosilicates with alkali hydroxides or alkali silicates. Various Industrial bye- products like Fly Ash (FA), Rice Husk Ash (RHA), Ground granulated Blast Furnace Slag (GGBFS), Silica Fume (SF), Red mud (RM) etc. are rich in aluminates and silicates. Using by-products from other industries reduces the carbon dioxide emission and thus giving a sustainable way of reducing greenhouse gas emissions and also a way to dispose the huge wastes generated from the major industries like thermal plants, steel plants, etc. The earlier research about geopolymer were focused on heat cured fly ash based precast members and this limited its applications. The heat curing mechanism itself is highly cumbersome and costly even though they possess high compressive strength, low drying shrinkage and creep, and good resistance to sulphate and acid environments. GPC having comparable strength and durability characteristics of OPC were able to develop under ambient cured conditions is the solution making it a sustainable alternative in future. In this paper an attempt has been made to review and compare the feasibility of ambient cured GPC over heat cured geopolymer concrete with respect to strength and serviceability characteristics. The variation on the behavior of structural members is also reviewed to identify the research gaps for future development of ambient cured geopolymer concrete. The comparison and analysis of studies showed that GPC most importantly ambient cured type has a comparable behavior with respect to OPC based concrete in terms strength and durability criteria.

Keywords: geopolymer concrete, oven heated, durability properties, mechanical properties

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Authors: Dini Dewi Heniarti

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Military Court which is a judicial institution within the military institution has a heavy duty. Military court has to ensuring a fair legal process for military personnel (due process of law) and enforces military discipline. Military justice must also ensure protects the rights of military personnel. In Indonesia tren of military court changes in vision. The debate is happened on the jurisdiction of military court that allegedly has the potential existence of impunity. The Decree of People’s Consultative Assembly Number VII/MPR/2000 which states that the army general who committed the crime should not be tried in military court is one that underlies the proposed amendment limits the jurisdiction of military court. For the identify of the background in a specific format that is limited to juridical review. The goals this research is to gain knowledge, deep understanding and the concept of jurisdiction of military courts for military members who committed general crimes in adjudication procedure from the perspective of legal reform as alternative to establish independency of military judiciary. This research using Rule of Law as Grand Theory, Development Legal Theory as a Middle Theory and Criminal Justice System and concept of jurisdiction as supporting as Applied Theory. This study using a normative juridical approach, and equipped by primary data juridical approach of historical and comparative approach. The author uses descriptive analytical specifications. The main data used in this research is secondary data, which includes primary legal materials, secondary legal material and legal materials tertiary. Analysis primary data and qualitative data is done legally. Technique checking the validity of the data in this study used multiple methods with the research triangulation. This paper will demonstrate the problems concerning the jurisdiction of military courts for military personnel who committed general crimes in perspective of military justice reform Indonesia and adjudication procedures for military member who committed general crimes in the military justice system in Indonesia, as alternative to establish independency of judiciary in military justice in Indonesia. Comparative approached the military justice system from another countries is aimed to development military justice in Indonesia.

Keywords: jurisdiction, military courts, military justice, independency of judiciary

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Authors: D. M. Cocârță, I. A. Istrate, C. Streche, D. M. Dumitru

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Soil contamination phenomena are a wide world issue that has received the important attention in the last decades. The main pollutants that have affected soils are especially those resulted from the oil extraction, transport and processing. This paper presents results obtained in the framework of a research project focused on the management of contaminated sites with petroleum products/ REMPET. One of the specific objectives of the REMPET project was to assess the electrochemical treatment (improved with polarity change respect to the typical approach) as a treatment option for the remediation of total petroleum hydrocarbons (TPHs) from contaminated soils. Petroleum hydrocarbon compounds attach to soil components and are difficult to remove and degrade. Electrochemical treatment is a physicochemical treatment that has gained acceptance as an alternative method, for the remediation of organic contaminated soils comparing with the traditional methods as bioremediation and chemical oxidation. This type of treatment need short time and have high removal efficiency, being usually applied in heterogeneous soils with low permeability. During the experimental tests, the following parameters were monitored: pH, redox potential, humidity, current intensity, energy consumption. The electrochemical method was applied in an experimental setup with the next dimensions: 450 mm x 150 mm x 150 mm (L x l x h). The setup length was devised in three electrochemical cells that were connected at two power supplies. The power supplies configuration was provided in such manner that each cell has a cathode and an anode without overlapping. The initial value of TPH concentration in soil was of 1420.28 mg/kg_dw. The remediation method has been applied for only 21 days, when it was already noticed an average removal efficiency of 31 %, with better results in the anode area respect to the cathode one (33% respect to 27%). The energy consumption registered after the development of the experiment was 10.6 kWh for exterior power supply and 16.1 kWh for the interior one. Taking into account that at national level, the most used methods for soil remediation are bioremediation (which needs too much time to be implemented and depends on many factors) and thermal desorption (which involves high costs in order to be implemented), the study of electrochemical treatment will give an alternative to these two methods (and their limitations).

Keywords: electrochemical remediation, pollution, total petroleum hydrocarbons, soil contamination

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Authors: Min Shi

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State of the art research with Artificial Neural Networks for the downscaling of General Circulation Models (GCMs) mainly uses back-propagation algorithm as a training approach. This paper introduces another training approach of ANNs, Evolutionary Algorithm. The combined algorithm names neuroevolutionary (NE) algorithm. We investigate and evaluate the use of the NE algorithms in statistical downscaling by generating temperature estimates at interior points given information from a lattice of surrounding locations. The results of our experiments indicate that NE algorithms can be efficient alternative downscaling methods for daily temperatures.

Keywords: temperature, downscaling, artificial neural networks, evolutionary algorithms

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Authors: Arfan Fadli, Marini Kristina Situmeang, Mukhammad Fatkhullah, Siti Hazar Sitorus

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Merantau is one of the traditions that has been done by the Minangkabau tribe since the 15th century where it is based on socio-economic factors. In fact, that is not only limited to economic factors alone but more how to develop themselves through the experience to get the skills or education. The lack of jobs opportunity in the hometown causes the community, especially for young men to seek livelihoods in other areas. Unemployment impacts on the economy of the community that led to change in the pattern of employment from farmers to traders or new businesses in areas outside of their homeland. This is also worsened because many young people are not interested in becoming a farmer and working on the land in their village. In this context, merantau is considered to be an alternative to fulfilling livelihoods, and therefore this study examines how the merantau tradition constructed by the Minangkabau community, West Sumatera Province. The research method is done by literature review by collecting information related to the social construction of merantau tradition from various scientific publications. The results show how merantau becomes a solution of economic problems for Minangkabau society. Merantau which has now become an institutionalized tradition for the Minangkabau community where the culture of merantau occurred like a chain that can raise the people from the condition of poverty. When there are people who have successfully in merantau, they tend to bring other relatives who have not found a job to be able to trade with them. In the place of merantau, they will be disciplined to learn how to trade. Eventually, they will have new skills to trade and even make their own business. The tradition of bringing relatives to the rantau to be empowered is a unique side of merantau because it is influenced by the Matrilinear kinship system. The matrilineal kinship system in Minangkabau is the largest in the world where helping relatives are considered to be of the highest value. This system also places men as high positions where men should be encouraged to go abroad for financial success and to help their relatives in their hometown. The success of this tradition (to uplift and resolve the poverty and manpower issues) is demonstrated by the tradition of Minangkabau communities that have been successful in the area of Rantau that send money to their relatives in their homes (remittance). Merantau tradition can also be an alternative in reducing unemployment especially for young people where it is demonstrated by the culture of helping relatives to get work outside of their homeland.

Keywords: matrilineal kinship system, merantau, minangkabau community, reducing unemployment

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.

Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies

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Authors: Wajeeha Zahid, Shafquat Rozi, Farhan Raza, Masood Kadir

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Background: Dental caries affects the overall health and well-being of children. Findings from various international studies regarding the association of dental caries with asthma are inconsistent. With the increasing burden of caries and childhood asthma, it becomes imperative for an underdeveloped country like Pakistan where resources are limited to identify whether there is a relationship between the two. This study aims to identify an association between dental caries and asthma. Methods: A cross-sectional study was conducted on 544 children aged 12-15 years recruited from five private schools in Karachi. Information on asthma was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The questionnaire addressed questions regarding child’s demographics, physician diagnoses of asthma, type of medication administered, family history of asthma and allergies, dietary habits and oral hygiene behavior. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth) index The data was analyzed using Cox proportional Hazard algorithm and crude and adjusted prevalence ratios with 95% CI were reported. Results: This study comprises of 306 (56.3%) boys and 238 (43.8%) girls. The mean age of children was 13.2 ± (0.05) years. The total number of children with carious teeth (DMFT > 0) were 166/544 (30.5%), and the decayed component contributed largely (22.8%) to the DMFT score. The prevalence of physician’s diagnosed asthma was 13%. This study identified almost 7% asthmatic children using the internationally validated International Study of Asthma and Allergies in Childhood (ISAAC) tool and 8 children with childhood asthma were identified by parent interviews. Overall prevalence of asthma was 109/544 (20%). The prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. The adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.59-1.29). After adjusting for carious food intake, age, oral hygiene index and dentist visit, the association between asthma and dental caries turned out to be non-significant. Conclusion: There was no association between asthma and dental caries among children who participated in this study.

Keywords: asthma, caries, children, school-based

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Authors: Swarupa Shashi Senivarapu Vemuri

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Curry leaf (Murraya koeinigii (L.)) exported from India had insecticide residues above maximum residue limits, which are hazardous to consumer health and caused rejection of the commodity at the point of entry in Europe and middle east resulting in a check on export of curry leaf. Hence to study current pesticide usage patterns in major curry leaf growing areas, a survey on pesticide use pattern was carried out in curry leaf growing areas in Guntur districts of Andhra Pradesh during 2014-15, by interviewing farmers growing curry leaf utilizing the questionnaire to assess their knowledge and practices on crop cultivation, general awareness on pesticide recommendations and use. Education levels of farmers are less, where 13.96 per cent were only high school educated, and 13.96% were illiterates. 18.60% farmers were found cultivating curry leaf crop in less than 1 acre of land, 32.56% in 2-5 acres, 20.93% in 5-10 acres and 27.91% of the farmers in more than 10 acres of land. Majority of the curry leaf farmers (93.03%) used pesticide mixtures rather than applying single pesticide at a time, basically to save time, labour, money and to combat two or more pests with single spray. About 53.48% of farmers applied pesticides at 2 days interval followed by 34.89% of the farmers at 4 days interval, and about 11.63% of the farmers sprayed at weekly intervals. Only 27.91% of farmers thought that the quantity of pesticides used at their farm is adequate, 90.69% of farmers had perception that pesticides are helpful in getting good returns. 83.72% of farmers felt that crop change is the only way to control sucking pests which damages whole crop. About 4.65% of the curry leaf farmers opined that integrated pest management practices are alternative to pesticides and only 11.63% of farmers felt natural control as an alternative to pesticides. About 65.12% of farmers had perception that high pesticide dose will give higher yields. However, in general, Curry leaf farmers preferred to contact pesticide dealers (100%) and were not interested in contacting either agricultural officer or a scientist. Farmers were aware of endosulfan ban 93.04%), in contrast, only 65.12, per cent of farmers knew about the ban of monocrotophos on vegetables. Very few farmers knew about pesticide residues and decontamination by washing. Extension educational interventions are necessary to produce fresh curry leaf free from pesticide residues.

Keywords: Curry leaf, decontamination, endosulfan, leaf roller, psyllids, tetranychid mite

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Authors: Saimir Heta, Ilma Robo, Rialda Xhizdari, Kers Kapaj

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The stability of an ideal disinfectant should be constant regardless of the change in the atmospheric conditions of the environment where it is kept. If the conditions such as temperature or humidity change, it is understood that it will also be necessary to approach possible changes in the holding materials such as plastic or glass bottles with the aim of protecting, for example, the disinfectant from the excessive lighting of the environment, which can also be translated as an increase in the temperature of disinfectant as a fluid. Material and Methods: In this study, an attempt was made to find the most recent published data about the best possible combination of disinfectants indicated for use after dental procedures. This purpose of the study was realized by comparing the basic literature that is studied in the field of dentistry by students with the most published data in the literature of recent years about this topic. Each disinfectant is represented by a number called the disinfectant count, in which different factors can influence the increase or reduction of variables whose production remains a specific statistic for a specific disinfectant. Results: The changes in the atmospheric conditions where the disinfectant is deposited and stored in the environment are known to affect the stability of the disinfectant as a fluid; this fact is known and even cited in the leaflets accompanying the manufactured boxes of disinfectants. It is these cares, in the form of advice, which are based not only on the preservation of the disinfectant but also on the application in order to have the desired clinical result. Aldehydes have the highest constant among the types of disinfectants, followed by acids. The lowest value of the constant belongs to the class of glycols, the predecessors of which were the halogens, in which class there are some representatives with disinfection applications. The class of phenols and acids have almost the same intervals of constants. Conclusions: If the goal were to find the ideal disinfectant among the large variety of disinfectants produced, a good starting point would be to find something unchanging or a fixed, unchanging element on the basis of which the comparison can be made properties of different disinfectants. Precisely based on the results of this study, the role of the specific constant according to the specific disinfectant is highlighted. Finding an ideal disinfectant, like finding a medication or the ideal antibiotic, is an ongoing but unattainable goal.

Keywords: different disinfectants, ideal, specific constant, dental procedures

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Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

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Klebsiella pneumoniae causes a wide range of infections, including urinary tract infections, sepsis, bacteremia, pneumonia, and liver abscesses. The emergence of multi-drug resistance in this bacterium led to a major setback for clinical management. WHO also endorsed a need for finding alternative therapy to antibiotics for the treatment of these infections. Development of vaccines and passive antibody therapy has been proven as a potent alternative to antibiotics in the case of MDR, XDR, and PDR Klebsiella infections. Siderophore receptors have been demonstrated to be overexpressed for the internalization of iron siderophore complexes during infections in most Gram-negative bacteria. For the present study, immune response to siderophore receptors to establish this protein as a potential immunogen for the development of therapeutic leads was explored. Clinical strains of Klebsiella pneumoniae were grown in iron-deficient conditions, and the iron-regulated outer membrane proteins were extracted and characterized through mass spectrometry for specific identification. The gene for identified protein was cloned in pET- 28a vector and expressed in E. coli. The native protein and the recombinant protein were isolated and purified and used as antigens for the generation of immune response in BALB/c mice. The native protein of Klebsiella pneumoniae grown in iron-deficient conditions was identified as FepA (Ferrienterobactin receptor) and other siderophore receptors. This 80 kDa protein generated an immune response in BALB/c mice. The antiserum from mice after subsequent booster doses was collected and showed binding with FepA protein in western blot and phagocytic uptake of the K. pneumoniae in the presence antiserum from immunized mice also observed from the animal studies after bacterial challenge post immunisation in mice have shown bacterial clearance. The antiserum from mice showed binding and clearance of the Klebsiella pneumoniae bacteria in vitro and in vivo. These antigens used for generating an active immune response in mice can further be used for therapeutic monoclonal antibody development against Klebsiella pneumoniae infections.

Keywords: antiserum, FepA, Klebsiella pneumoniae, multi drug resistance, siderophore receptor

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Authors: A. Babou, Y. Kerboua Ziari, Y. Kerkoub

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The risks of depletion of fossil fuel reserves and environmental problems caused by their consumption cause to consider alternative energy solutions. Hydrogen appears as a serious solution because its combustion produces only water. The objective of this study is to digitally analyze the effect of operating conditions on the process of absorption of hydrogen in a tank of metal hydride alloy Lanthanum - Nickel (LaNi 5). For this modeling of heat transfer and mass in the tank was carried .The results of numerical weather prediction are in good agreement with the experimental results.

Keywords: hydrogen, storage, energy, fuel, simulation

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Authors: Sui Yan Wong, Keat Ping Yeoh, Chi Wai Hui

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In this study, supercritical steam is introduced to Combined Cycle Power Plant (CCPP) in an attempt to further optimize energy recovery. Subcritical steam is commonly used in the CCPP, operating at maximum pressures around 150-160 bar. Supercritical steam is an alternative to increase heat recovery during vaporization period of water. The idea of improvement using supercritical steam is further examined with the use of exergy, pinch analysis and Aspen Plus simulation.

Keywords: exergy, pinch, combined cycle power plant, supercritical steam

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Authors: Aparna Soni

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The much-celebrated foretold story of Indian city engines driving the growth of India has been scrutinized to have serious consequences. A wide spectrum of scholarship has brought to light the un-equalizing effects and the need to adopt a rights-based approach to development planning in India. Notably, these concepts and discourses ubiquitously entail the study of land struggles in the making of Urban. In fact, the very progression of the primitive accumulation theory to accumulation by dispossession, followed by ‘dispossession without development,’ thereafter Development without dispossession and now as Dispossession by financialization noticeably the last three developing in a span of mere three decades, is evidence enough to trace the centrality and evolving role of land in the making of urban India. India, in the last decade, has seen its regional governments actively experimenting with alternative models of land assembly (Amaravati and Delhi land pooling models, the loudly advertised ones). These are publicized as a replacement to the presumably cost and time antagonistic, prone to litigation land acquisition act of 2013. It has been observed that most of the literature treats these models as a generic large bracket of land expropriation and do not, in particular, try to differentially analyse to granularly find a pattern in these alternatives. To cater to this gap, this research comparatively studies these alternative land, assembly models. It categorises them based on their basic architecture, spatial and sectoral application, and governance frameworks. It is found that these alternatives are ad-hoc and fragmented pieces of legislation. These are fit for profit models commodifying land to ease its access by the private sector for real estate led growth. The research augments the literature on the privatization of land use planning in India. Further, it attempts to discuss the increasing role a landowner is expected to play in the future and suggests a way forward to safeguard them from market risks. The study involves a thematic analysis of the policy elements contained in legislative/policy documents, notifications, office orders. The study also derives from the various widely circulated print media information. With the present field-visit limitations, the study relies on documents accessed open-source in the public domain.

Keywords: commodification, dispossession, land acquisition, landowner

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Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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Compressed natural gas (CNG) represents an excellent compromise between the availability of a technology that is proven and relatively easy to use in many areas of the automotive industry and incurred costs. This fuel causes a lower corrosion effect due to the lower content of products causing the potential difference on the walls of the engine system. Natural gas powered vehicles (NGVs) do not emit any substances that can contaminate water or land. The absence of carcinogenic substances in gaseous fuel extends the life of the engine. In the longer term, it contributes positively to waste management as well as waste disposal. Popularization of propulsion systems powered by natural gas CNG positively affects the reduction of heavy duty transport. For these reasons, CNG as a fuel stimulates considerable interest around the world. Over the last few years, technologies related to use of natural gas as an engine fuel have been developed and improved. These solutions have evolved from the prototype phase to the industrial scale implementation. The widespread availability of gaseous fuels has led to the development of a technology that allows the CNG fuel to be refueled directly from the urban gas network to the vehicle tank (ie. HYGEN - CNGHRS). Home refueling installations, although they have been known for many years, are becoming increasingly important in the present day. The major obstacle in the sale of this technology was, until recently, quite high capital expenditure compared to the later benefits. Home refueling systems allow refueling vehicle tank, with full control of fuel costs and refueling time. CNG Home Refueling Stations (such as HYGEN) allow gas value chain to overcome the dogma that there is a lack of refueling infrastructure allowing companies in gas value chain to participate in transportation market. Technology is based on one stage hydraulic compressor (instead of multistage mechanical compressor technology) which provides the possibility to compress low pressure gas from distribution gas network to 200 bar for its further usage as a fuel for NGVs. This boosts revenues and profits of gas companies by expanding its presence in higher margin of energy sector.

Keywords: alternative fuels, CNG (compressed natural gas), CNG stations, NGVs (natural gas vehicles), gas value chain

Procedia PDF Downloads 200

Authors: Yimeng Zhang

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Major depressive disorder (MDD) is a prevalent mental health condition with a substantial economic impact and limited treatment options. Acupuncture has gained attention as a promising non-pharmacological intervention for alleviating depressive symptoms. However, its mechanisms and clinical effectiveness remain incompletely understood. This meta-analysis aims to (1) synthesize existing evidence on the mechanisms and clinical effectiveness of acupuncture for depression and (2) compare these findings with pharmacological interventions, providing insights for future research. Evidence from animal models and clinical studies indicates that acupuncture may enhance hippocampal and network neuroplasticity and reduce brain inflammation, potentially alleviating depressive disorders. Clinical studies suggest that acupuncture can effectively relieve primary depression, particularly in milder cases, and is beneficial in managing post-stroke depression, pain-related depression, and postpartum depression, both as a standalone and adjunctive treatment. Notably, combining acupuncture with antidepressant pharmacotherapy appears to enhance treatment outcomes and reduce medication side effects, addressing a critical issue in conventional drug therapy's high dropout rates. This meta-analysis, encompassing 12 studies and 710 participants, draws data from eight digital databases (PubMed, EMBASE, Web of Science, EBSCOhost, CNKI, CBM, Wangfang, and CQVIP) covering the period from 2012 to 2022. Utilizing Stata software 15.0, the meta-analysis employed random-effects and fixed-effects models to assess the distribution of depression in Traditional Chinese Medicine (TCM). The results underscore the substantial evidence supporting acupuncture's beneficial effects on depression. However, the small sample sizes of many clinical trials raise concerns about the generalizability of the findings, indicating a need for further research to validate these outcomes and optimize acupuncture's role in treating depression.

Keywords: Chinese medicine, acupuncture, depression, meta-analysis

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Authors: Asma Chbani, Douaa Salim, Josephine Al Alam, Pascale De Caro

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Penicillium digitatum, the causal agent of citrus green mold, is responsible for 90% of post-harvest losses. Chemical fungicides remain the most used products for protection against this pathogen but are also responsible for damage to human health and the environment. The aim of this study is to evaluate the ability of Spinacia oleracea extract to serve as biological control agents, an alternative to harmful synthetic fungicides, against orange decay for storing fruit caused by P. digitatum. In this study, we studied the implication of a crude extract of a green plant, Spinacia oleracea, in the protection of oranges against P. digitatum. Thus, in vivo antifungal tests as well as adhesion test were done. For in vivo antifungal test, oranges were pulverized with the prepared crude extracts at different concentrations ranged from 25 g L⁻¹ to 200 g L⁻¹, contaminated by the fungus and then observed during 8 weeks for their macroscopic changes at 24°C. For adhesion test, the adhesion index is defined as the number of Penicillium digitatum spores fixed per orange cell. An index greater than 25 is the indicator of a strong adhesion, whereas for an index less than 10, the adhesion is low. Ten orange cells were examined in triplicate for each extract, and the averages of adherent cells were calculated. Obtained results showed an inhibitory activity of the Penicillium development with the aqueous extract of dry Spinacia oleracea with a concentration of 50 g L⁻¹ considered as the minimal protective concentration. The prepared extracts showed a greater inhibition of the development of P. digitatum up to 10 weeks, even greater than the fungicide control Nystatin. Adhesion test’s results showed that the adhesion of P. digitatum spores to the epidermal cells of oranges in the presence of the crude spinach leaves extract is weak; the mean of the obtained adhesion index was estimated to 2.7. However, a high adhesion was observed with water used a negative control. In conclusion, all these results confirm that the use of this green plant highly rich in chlorophyll having several phytotherapeutic activities, could be employed as a great treatment for protection of oranges against mold and also as an alternative for chemical fungicides.

Keywords: Penicillium digitatum, Spinacia oleracea, oranges, biological control, postharvest diseases

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Authors: Abdul Halim Abdul Razik, Ali Elkamel, Leonardo Simon

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Wheat straw is one of the alternative feedstocks that may be utilized for bioethanol production especially when sustainability criteria are the major concerns. To increase market competitiveness, optimal supply chain plays an important role since wheat straw is a seasonal agricultural residue. In designing the supply chain optimization model, economic profitability of the thermochemical and biochemical conversion routes options were considered. It was found that torrefied pelletization with gasification route to be the most profitable option to produce bioethanol from the lignocellulosic source of wheat straw.

Keywords: bio-ethanol, optimization, supply chain, wheat straw

Procedia PDF Downloads 736

Authors: Marina G. Galitskaya, Svetlana G. Makarova, Andrey P. Fisenko.

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Children on medication-induced immunosuppression are at high risk of developing severe course infectious diseases. Therefore, preventive vaccination is especially important for these children. However, due to the immunosuppressive effects of treatment for the underlying disease, the effectiveness of vaccination may decrease below the protective level. In a multidisciplinary children's medical center, post-vaccination immunity was studied in 79 children aged 4-17 years. The children were divided into 2 groups: Group 1 (38 children) with kidney pathology (Nephrotic Syndrome) and Group 2 (41 children) with inflammatory bowel diseases (Ulcerative Colitis, Crohn's Disease). Both groups of children were vaccinated according to the national vaccination calendar and received immunosuppressive therapy (prednisolone, methotrexate, cyclosporine, and other drugs) for at least 1 year. Using the enzyme-linked immunosorbent assay method, specific IgG antibodies to vaccine-preventable infections were determined: measles, rubella, mumps, diphtheria, pertussis, tetanus, and hepatitis B. The study showed the percentage of children with positive IgG values for vaccine-preventable infections. The highest percentage of children had protective antibody levels to measles (84.2% in children with nephrotic syndrome and 92.6% in those with inflammatory bowel disease) and rubella (71% and 80.4%, respectively). The lowest percentage of children with protective antibodies was for hepatitis B (5.2% and 29.2% respectively). Antibodies to mumps, diphtheria, pertussis, and tetanus were found not in all children (from 39,4% to 82,9%). The remaining percentage of children did not have detectable IgG antibodies to vaccine-preventable infections. Not all children, despite the previous vaccination, preserved antibodies to vaccine-controlled infections and remained unprotected by specific IgG antibodies. The issue of a booster vaccine dose should be considered in children without contraindications to vaccination. Children receiving long-term immunosuppressive therapy require an individual vaccination approach, including a specific definition of the performed vaccination.

Keywords: immunosuppressive therapy, inflammatory bowel diseases, nephrotic syndrome, post-vaccination immunity, specific antibodies, vaccine-preventable infections.

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Authors: Z. Neffah, L. Merabti, N. Hatraf

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Absorption refrigeration technology has been used for cooling purposes over a hundred years. Today, the technology developments have made of the absorption refrigeration an economic and effective alternative to the vapour compression cooling cycle. A parametric study was conducted over the entire admissible ranges of the generator and absorber temperatures. On the other hand, simultaneously raising absorber temperatures was seen to result in deterioration of coefficient of performance. The influence of generator, absorber temperatures, as well as solution concentration on the different performance indicators was also calculated and examined.

Keywords: absorption system, Aqueous solution, chiller, water-lithium bromide

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Authors: Fulya Zaralı, Harun Resit Yazgan

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Logistics centers represent areas that all national and international logistics and activities related to logistics can be implemented by the various businesses. Logistics centers have a key importance in joining the transport stream and the transport system operations. Therefore, it is important where these centers are positioned to be effective and efficient and to show the expected performance of the centers. In this study, the location selection problem to position the logistics center is discussed. Alternative centers are evaluated according certain criteria. The most appropriate center is identified using the axiomatic design method.

Keywords: axiomatic design, logistic center, facility location, information systems

Procedia PDF Downloads 348

Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.

Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program

Procedia PDF Downloads 243