Search results for: post facial syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5154

Search results for: post facial syndrome

4344 The Addition of Opioids to Bupivacaine in Bilateral Infraorbital Nerve Block for Postoperative Pain Relief in Paediatric Patients for Cleft Lip Repair-Comparative Effects of Pethidine and Fentanyl: A Prospective Randomized Double Blind Study

Authors: Mrudula Kudtarkar, Rajesh Mane

Abstract:

Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

Procedia PDF Downloads 231
4343 Polycystic Ovarian Syndrome (PCOS) as an Evolutionary Mismatch Disorder: An Argument for the Significance of Hyperandrogenism on Reproductive Fitness in Ancestral Populations

Authors: Courtney Manthey-Pierce, Anna Warrener

Abstract:

Polycystic ovarian syndrome (PCOS) is the most common endocrine disruptive disorder in females. PCOS is primarily characterized by polycystic ovaries, anovulation, hirsutism, insulin resistance, and hyperandrogenism. Despite negative reproductive consequences for females from anovulation and endocrine dysfunction, genes associated with the pathogenesis of PCOS are highly hereditable (h2 = 0.72). An evolutionary mismatch occurs when a trait that evolved in one environment has become maladaptive in another environment. The idea that PCOS is an evolutionary mismatch disease has been promoted by several researchers. Each trait of the resulting PCOS phenotype should be investigated individually in order to demonstrate an evolutionary mismatch. Hyperandrogenism is often regarded as the main characteristic of PCOS Hyperandrogenism may have aided with conception in older females, increased bone mineral density, and supported prolonged breastfeeding in nutritionally distressed populations. Because of the high prevalence of PCOS in the modern world, approximately 6%, it is often argued that PCOS emerged in an ancestral population prior to the migration out of Africa approximately 200,000 years ago. This environment would be characterized by sporadic periods of nutrition deficit and resource hardships as the climate began changing. Presently, modern society is characterized by obesity and sedentary lifestyles. The prevalence of obesity renders hyperandrogenism PCOS useless as there are no periods of nutritional distress requiring androgens for increased reproductive rates. In an ancestral environment, hyperandrogenism would likely lead to sporadic anovulation and mild secondary symptoms, however high levels of androgens in a modern environment led to prolonged if not permanent infertility and excessive secondary problems. Thus, hyperandrogenism related to PCOS appears to meet evolutionary mismatch criteria. Seen in this light, PCOS may be effectively treated as a probably evolutionary mismatch.

Keywords: evolutionary mismatch, heritability, hyperandrogenism, mismatch disorder

Procedia PDF Downloads 239
4342 To Study the New Invocation of Biometric Authentication Technique

Authors: Aparna Gulhane

Abstract:

Biometrics is the science and technology of measuring and analyzing biological data form the basis of research in biological measuring techniques for the purpose of people identification and recognition. In information technology, biometrics refers to technologies that measure and analyze human body characteristics, such as DNA, fingerprints, eye retinas and irises, voice patterns, facial patterns and hand measurements. Biometric systems are used to authenticate the person's identity. The idea is to use the special characteristics of a person to identify him. These papers present a biometric authentication techniques and actual deployment of potential by overall invocation of biometrics recognition, with an independent testing of various biometric authentication products and technology.

Keywords: types of biometrics, importance of biometric, review for biometrics and getting a new implementation, biometric authentication technique

Procedia PDF Downloads 317
4341 Microbiota Effect with Cytokine in Hl and NHL Patient Group

Authors: Ekin Ece Gürer, Tarık Onur Tiryaki, Sevgi Kalayoğlu Beşışık, Fatma Savran Oğuz, Uğur Sezerman, Fatma Erdem, Gülşen Günel, Dürdane Serap Kuruca, Zerrin Aktaş, Oral Öncül

Abstract:

Aim: Chemotherapytreatment in HodgkinLymphomaandNon-HodgkinLymphoma (NHL) diseasescausesgastrointestinalepithelialdamage, disruptstheintestinalmicrobiotabalanceandcausesdysbiosis. Inourstudy, it wasaimedtoshowtheeffect of thedamagecausedbychemotherapy on themicrobiotaandtheeffect of thechangingmicrobiota flora on thecourse of thedisease. Materials And Methods: Seven adult HL and seven adult HL patients to be treatedwithchemotherapywereincluded in the study. Stoolsamplesweretakentwice, beforechemotherapytreatmentandafterthe 3th course of treatment. SamplesweresequencedusingNextGenerationSequencing (NGS) methodafternucleicacidisolation. OTU tableswerepreparedusing NCBI blastnversion 2.0.12 accordingtothe NCBI general 16S bacterialtaxonomyreferencedated 10.08.2021. Thegenerated OTU tableswerecalculatedwith R Statistical Computer Language version 4.04 (readr, phyloseq, microbiome, vegan, descrand ggplot2 packages) to calculate Alpha diversityandtheirgraphicswerecreated. Statistical analyzeswerealsoperformedusing R Statistical Computer Language version 4.0.4 and studio IDE 1.4 (tidyverse, readr, xlsxand ggplot2 packages). Expression of IL-12 and IL-17 cytokineswasperformedbyrtPCRtwice, beforeandaftertreatment. Results: InHL patients, a significantdecreasewasobserved in themicrobiota flora of Ruminococcaceae_UCG-014 genus (p:0.036) andUndefined Ruminococcaceae_UCG-014 species (p:0.036) comparedtopre-treatment. When the post-treatment of HL patientswerecomparedwithhealthycontrols, a significantdecreasewasfound in themicrobiota of Prevotella_7 genus (p:0.049) andButyricimonas (p:0.006) in the post-treatmentmicrobiota of HL patients. InNHL patients, a significantdecreasewasobserved in themicrobiota flora of Coprococccus_3 genus (p:0.015) andUndefined Ruminoclostridium_5 (p:0.046) speciescomparedtopre-treatment. When post-treatment of NHL patientswerecomparedwithhealthycontrols, a significantabundance in theBacilliclass (p:0.029) and a significantdecrease in theUndefinedAlistipesspecies (p:0.047) wereobserved in the post-treatmentmicrobiota of NHL patients. While a decreasewasobserved in IL-12 cytokineexpressionuntilbeforetreatment, an increase in IL-17 cytokineexpressionwasdetected. Discussion: Intestinal flora monitoringafterchemotherapytreatmentshowsthat it can be a guide in thetreatment of thedisease. It is thoughtthatincreasingthediversity of commensalbacteria can alsopositivelyaffecttheprognosis of thedisease.

Keywords: hodgkin lymphoma, non-hodgkin, microbiota, cytokines

Procedia PDF Downloads 103
4340 Hilotherapy in Orthognathic Surgery

Authors: N. Gharooni-Dowrani, B. Gharooni-Dowrani

Abstract:

The benefits of hilotherapy following orthogonathic surgery have been explored in recent years, demonstrating reduction in patient pain and swelling post-operatively. However, hilotherapy is not always widely accessible to all patients following orthognathic surgery. In this study, 50 patients were examined at Luton and Dunstable Hospital, half (25) of which used hilotherm masks post operatively and half of which opted for traditional ice packs in order to aid recovery. This study demonstrated that the use of hilotherapy reduced patient pain when analgesia need and use were analysed, as well as shortening inpatient stay. Although no current hilotherm masks are available without rental services in our trust, this study demonstrated the positive outcomes that they may bring, which may be worth future investment for our department.

Keywords: orthognathic surgery, orthodontics, hilotherapy, OMFS

Procedia PDF Downloads 79
4339 Effects of a 6-Month Caloric Restriction Induced-Weight Loss Program in Obese Postmenopausal Women with and without the Metabolic Syndrome: A MONET Study

Authors: Ahmed Ghachem, Denis Prud’homme, Rémi-Rabasa-Lhoret, M. Brochu

Abstract:

Objective: To compare the effects of a CR on body composition, lipid profile and glucose homeostasis in obese postmenopausal women with and without MetS. Methods: Secondary analyses were performed on seventy-three inactive obese postmenopausal women (age: 57.7 ± 4.8 yrs; body mass index: 32.4 ± 4.6 kg/m2) who participated in the 6-month caloric restriction arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorized participants with MetS [n = 20, 27.39%] and without MetS [n = 53, 72.61%]. Variables of interest were: body composition (DXA), body fat distribution (CT scan), glucose homeostasis at the fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids and resting blood pressure. Results: By design, the MetS group had a worse cardiometabolic profile; while both groups were comparable for age. Fifty-five patients out of seventy-three displayed no change in MetS status after the intervention. Twelve participants out of twenty (or 60.0%) in the MetS group had no more MetS after weight loss (P= NS); while six participants out of fifty three (or 11.3%) in the other group developed the MetS after the intervention (P= NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/HDL-C ratio, which decrease significantly more in the MetS group (P ≤ 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile. Conclusion: Despite no overall significant effects on MetS, heterogeneous results were obtained in response to weight loss in the present study; with some improving the MetS while other displaying deteriorations. Further studies are needed in order to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.

Keywords: menopause, obesity, physical inactivity, metabolic syndrome, caloric restriction, weight loss

Procedia PDF Downloads 338
4338 The Effect of Two Methods of Upper and Lower Resistance Exercise Training on C-Reactive Protein, Interleukin-6 and Intracellular Adhesion Molecule-1 in Healthy Untrained Women

Authors: Leyla Sattarzadeh, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

Abstract:

Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6) and adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of resistance exercise training on these inflammatory markers, the present study aimed to examine the effect of eight week different patterns of resistance exercise training on CRP, IL-6 and ICAM-1 levels in healthy untrained women. 40 volunteered and healthy untrained female university students (aged: 21+ 3 yr., Body Mass Index: 21.5+ 3.5 kg/m2) were selected purposefully and divided into three groups. At the end of training protocol and after subjects drop during the protocol in upper body exercise training (n=11), lower body (n=12) completed the eight week of training period although the control group (n=7) did anything. Blood samples gathered pre and post experimental period and CRP, IL-6 and ICAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one way Analysis of Variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP and ICAM-1 showed no significant changes due to the exercise training. But there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper and lower body exercise training by involving the different amount of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP and ICAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: C-reactive protein, interleukin-6, intracellular adhesion molecule-1, resistance training

Procedia PDF Downloads 251
4337 Youth Participation in Peace Building and Development in Northern Uganda

Authors: Eric Awich Ochen

Abstract:

The end of the conflict in Northern Uganda in 2006 brought about an opportunity for the youth to return to their original home and contribute to the peace building and development process of their communities. Post-conflict is used here to refer to the post-armed conflict situation and activities of rebels of Joseph Kony in northern Uganda. While the rebels remain very much active in the Sudan and Central African Republic, in Uganda the last confrontations occurred around 2006 or earlier, and communities have returned to their homes and began the process of rebuilding their lives. It is argued that socio-economic reconstruction is at the heart of peacebuilding and sustenance of positive peace in the aftermath of conflict, as it has a bearing on post-conflict stability and good governance. We recognize that several post-conflict interventions within Northern Uganda have targeted women and children with a strong emphasis on family socio-economic empowerment and capacity building, including access to micro finance. The aim of this study was to examine the participation of the youth in post-conflict peace building and development in Northern Uganda by assessing the breadth and width of their engagement and the stages of programming cycle that they are involved in, interrogating the space for participation and how they are facilitating or constraining participation. It was further aimed at examining the various dimensions of participation at play in Northern Uganda and where this fits within the conceptual debates on peace building and development in the region. Supporting young people emerging out of protracted conflict to re-establish meaningful socio-economic engagements and livelihoods is fundamental to their participation in the affairs of the community. The study suggests that in the post-conflict development context of Northern Uganda, participation has rarely been disaggregated or differentiated by sectors or groups. Where some disaggregation occurs, then the main emphasis has always been on either women or children. It appears therefore that little meaningful space has thus been created for young people to engage and participate in peace building initiatives within the region. In other cases where some space is created for youth participation, this has been in pre-conceived programs or interventions conceived by the development organizations with the youth or young people only invited to participate at particular stages of the project implementation cycle. Still within the implementation of the intervention, the extent to which young people participate is bounded, with little power to influence the course of the interventions or make major decisions. It is thus visible that even here young people mainly validate and legitimize what are predetermined processes only act as pawns in the major chess games played by development actors (dominant peace building partners). This paper, therefore, concludes that the engagement of the youth in post-conflict peace building has been quite problematic and tokenistic and has not given the adequate youth space within which they could ably participate and express themselves in the ensuing interventions.

Keywords: youth, conflict, peace building, participation

Procedia PDF Downloads 393
4336 The Students' Mathematical Competency and Attitude towards Mathematics Using the Trachtenberg Speed Math System

Authors: Marlone D. Severo

Abstract:

A pre- and post-test quasi-experimental design was used to test the intervention of Trachtenberg Speed Math on the mathematical competency of sixty (60) matched-paired students with a poor performing grade in Mathematics from one of the biggest public national high school at the South of Metro Manila. Both control and experimental group were administered with the Attitude Towards Mathematics Inventory (ATMI) before the pretest were given and both group showed high dislike for Mathematics. Pretest showed a 53 percent accuracy for the control group and 51 percent for the experimental group using a 15-item long multiplication test without any aid of a computing device. The experimental group were taught how to use the Trachtenberg number-keys and techniques in multiplication between October 2014 to March 2015. Post-test showed an improvement in the experimental group with 96 percent accuracy for the control group and a dismal 57 percent for the control group in long-multiplication. Post-test ATMI were administered. The control group showed a great dislike towards Mathematics, while the experimental group showed a positive attitude towards the subject.

Keywords: attitude towards mathematics, mathematical competency, number-keys, trachtenberg speed math

Procedia PDF Downloads 365
4335 Effects of an Envious Experience on Schadenfreude and Economic Decisions Making

Authors: Pablo Reyes, Vanessa Riveros Fiallo, Cesar Acevedo, Camila Castellanos, Catalina Moncaleano, Maria F. Parra, Laura Colmenares

Abstract:

Social emotions are physiological, cognitive and behavioral phenomenon that intervene in the mechanisms of adaptation of individuals and their context. These are mediated by interpersonal relationship and language. Such emotions are subdivided into moral and comparison. The present research emphasizes two comparative emotions: Envy and Schadenfreude. Envy arises when a person lack of quality, possessions or achievements and these are superior in someone else. The Schadenfreude (SC) expresses the pleasure that someone experienced by the misfortune of the other. The relationship between both emotions has been questioned before. Hence there are reports showing that envy increases and modulates SC response. Other documents suggest that envy causes SC response. However, the methodological approach of the topic has been made through self-reports, as well as the hypothetical scenarios. Given this problematic, the neuroscience social framework provides an alternative and demonstrates that social emotions have neurophysiological correlates that can be measured. This is relevant when studying social emotions that are reprehensible like envy or SC are. When tested, the individuals tend to report low ratings due to social desirability. In this study, it was drawn up a proposal in research's protocol and the progress on its own piloting. The aim is to evaluate the effect of feeling envy and Schadenfreude has on the decision-making process, as well as the cooperative behavior in an economic game. To such a degree, it was proposed an experimental model that will provoke to feel envious by performing games against an unknown opponent. The game consists of asking general knowledge questions. The difficulty level in questions and the strangers' facial response have been manipulated in order to generate an ecological comparison framework and be able to arise both envy and SC emotions. During the game, an electromyography registry will be made for two facial muscles that have been associated with the expressiveness of envy and SC emotions. One of the innovations of the current proposal is the measurement of the effect that emotions have on a specific behavior. To that extent, it was evaluated the effect of each condition on the dictators' economic game. The main intention is to evaluate if a social emotion can modulate actions that have been associated with social norms, in the literacy. The result of the evaluation of a pilot model (without electromyography record and self-report) have shown an association between envy and SC, in a way that as the individuals report a greater sense of envy, the greater the chance to experience SC. The results of the economic game show a slight tendency towards profit maximization decisions. It is expected that at the time of using real cash this behavior will be strengthened and also to correlate with the responses of electromyography.

Keywords: envy, schadenfreude, electromyography, economic games

Procedia PDF Downloads 366
4334 Acute Bronchiolitis: Impact of an Educational Video on Mothers’ Knowledge, Attitudes, and Practices

Authors: Atitallah Sofien, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Bouyahia Olfa, Boukthir Samir

Abstract:

Introduction: Acute bronchiolitis (AB) is a real public health problem on a global and national scale. Its treatment is most often outpatient. The use of audio-visual supports, such as educational videos, is an innovation in therapeutic education in outpatient treatment. The aim of our study was to evaluate the impact of an educational video on the knowledge, attitudes, and practices of mothers of infants with AB. Methodology: This was a descriptive, analytical, and cross-sectional study with prospective data collection, including mothers of infants with AB. We assessed mothers' knowledge, attitudes, and practices regarding AB, and we created an educational video. We used a questionnaire written in Tunisian Arabic concerning sociodemographic data, mothers' knowledge and attitudes regarding AB, and their opinions on the video, as well as an observation grid to evaluate their practices on the nasopharyngeal unblocking technique. We compared the different parameters before and after watching the video. Results: We noted a statistically significant improvement in mothers' knowledge scores on AB (7.46 in the pre-test versus 14.08 in the post-test; p≤0.05), practices (12.42 in the pre-test versus 18 in the post-test; p≤0.05) and attitudes (5.86 in pre-test versus 9.02 in post-test; p≤0.05). Conclusion: The use of an educational video has a positive impact on the knowledge, practices, and attitudes of mothers towards AB.

Keywords: acute bronchiolitis, therapeutic education, mothers, educational video

Procedia PDF Downloads 64
4333 Biostimulation Effect of Ozone Therapy and Superficial Peeling on Facial Rejuvenation: A Case Report and Literature Review

Authors: Ferreira R., Rocha K.

Abstract:

Ozone therapy is indicated for improving skin aesthetics, adjusting oxidative tissue levels, increasing collagen production, and even skin volumizing. This paper aims to carry out a case report that demonstrates the positive results of ozone therapy in association with superficial peeling. The application in association showed positive results for bio-stimulating activities in the reported case demonstrating to be a viable clinical technique. The bio-stimulating effect of ozone therapy in association with peeling is a promising aesthetic therapeutic modality with fast and safe results as an aesthetic therapeutic option.

Keywords: bio-stimulating effect, ozone therapy, neocollagenesis, peeling

Procedia PDF Downloads 96
4332 Effect of Migraine on Functional Performance and Reported Symptoms in Children with Concussion

Authors: Abdulaziz Alkathiry

Abstract:

Concussion is a common brain injury that affect physical and cognitive performance. While several studies indicated that adolescents are more likely to develop concussion, in the last decade concussion has been mainly explored in adults. Migraine has been identified as a common symptom reported after concussion and was tied with worse prognoses. Hence, we aimed to investigate the effect of migraine on functional performance and self-reported symptoms in children with concussion. This cross-sectional study involved 35 symptomatic children aged 9 – 17 years recruited within 1 year from their concussion injury at a tertiary balance center. Participants’ symptoms and functional performance were assessed using the post-concussion symptoms scale (PCSS) and the functional gait assessment (FGA) respectively. Concussed children with migraine showed significantly worse symptoms including fatigue, sleeping impairment, difficulty concentrating, and visual problems (P < 0.05). Functional performance didn’t show differences between concussed children with and without migraine. Although concussed children with and without migraine didn’t show any differences on functional performance, worse cognitive symptoms were found in concussed children with migraine. A customized treatment approach is indicated in the presence of migraine for the management of children with concussion. Keywords: Concussion; Migraine; Balance; Post-Concussion Symptoms Scale; Functional Gait Assessment

Keywords: concussion, migraine, post-concussion symptoms scale, functional gait assessment, balance

Procedia PDF Downloads 338
4331 Examining Pre-Consumer Textile Waste Recycling, Barriers to Implementation, and Participant Demographics: A Review of Literature

Authors: Madeline W. Miller

Abstract:

The global textile industry produces pollutants in the form of liquid discharge, solid waste, and emissions into the natural environment. Textile waste resulting from garment production and other manufacturing processes makes a significant contribution to the amount of waste landfilled globally. While the majority of curbside and other convenient recycling methods cater to post-consumer paper and plastics, pre-consumer textile waste is often discarded with trash and is commonly classified as ‘other’ in municipal solid waste breakdowns. On a larger scale, many clothing manufacturers and other companies utilizing textiles have not yet identified or began using the most sustainable methods for discarding their post-industrial, pre-consumer waste. To lessen the amount of waste sent to landfills, there are post-industrial, pre-consumer textile waste recycling methods that can be used to give textiles a new life. This process requires that textile and garment manufacturers redirect their waste to companies that use industrial machinery to shred or fiberize these materials in preparation for their second life. The goal of this literature review is to identify the recycling and reuse challenges faced by producers within the clothing and textile industry that prevent these companies from utilizing the described recycling methods, causing them to opt for landfill. The literature analyzed in this review reflects manufacturer sentiments toward waste disposal and recycling. The results of this review indicate that the cost of logistics is the determining factor when it comes to companies recycling their pre-consumer textile waste and that the most applicable and successful textile waste recycling methods require a company separate from the manufacturer to account for waste production, provide receptacles for waste, arrange waste transport, and identify a secondary use for the material at a price-point below that of traditional waste disposal service.

Keywords: leadership demographics, post-industrial textile waste, pre-consumer textile waste, industrial shoddy

Procedia PDF Downloads 148
4330 Enhancing Secondary School Mathematics Retention with Blended Learning: Integrating Concepts for Improved Understanding

Authors: Felix Oromena Egara, Moeketsi Mosia

Abstract:

The study aimed to evaluate the impact of blended learning on mathematics retention among secondary school students. Conducted in the Isoko North Local Government Area of Delta State, Nigeria, the research involved 1,235 senior class one (SS 1) students. Employing a non-equivalent control group pre-test-post-test quasi-experimental design, a sample of 70 students was selected from two secondary schools with ICT facilities through purposive sampling. Random allocation of students into experimental and control groups was achieved through balloting within each selected school. The investigation included three assessment points: pre-Mathematics Achievement Test (MAT), post-MAT, and post-post-MAT (retention), administered systematically by the researchers. Data collection utilized the established MAT instrument, which demonstrated a high reliability score of 0.86. Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 28, with mean and standard deviation addressing study questions and analysis of covariance scrutinizing hypotheses at a significance level of .05. Results revealed significantly greater improvements in mathematics retention scores among students exposed to blended learning compared to those instructed through conventional methods. Moreover, noticeable differences in mean retention scores were observed, with male students in the blended learning group exhibiting notably higher performance. Based on these findings, recommendations were made, advocating for mathematics educators to integrate blended learning, particularly in geometry teaching, to enhance students’ retention of mathematical concepts.

Keywords: blended learning, flipped classroom model, secondary school students, station rotation model

Procedia PDF Downloads 40
4329 The Emerging Post-Islamism and the Politics of Pakistan’s Jamaat-i-Islami in the Contemporary Muslim World

Authors: Shahzada Gulfam

Abstract:

Islamism was considered as a new phenomenon in Muslim World to revolt against static Religious Traditionalists and the Imperialists. Islamist political parties viewed the establishment of an Islamic state within the limits of Sharia’h as their destination. The Islamists movements like Ikhwan-ul Muslimun, Jamaat-i-Islami etc. did appear with revolutionary agenda but were contained by military forces and the secular modernists of Muslim World. The Muslim rulers, historically could not respect the democratic and moral norms and equally emerged as dictators in democracies, military rule as well as in monarchies. The Arab Spring did not follow the Islamists agenda but gathered the common masses against the corrupt rulers to have a just democratic political system. The Islamic State and Sharia’h were not their immediate targets but the achievement of moral norms in Muslim societies and eradication of dictatorial rule were the basic aims. This phenomenon is named as post-Islamism. The political struggle of PAT (Pakistan Awami Tehreek) and the PTI (Pakistan Tehreek-i-Insaf) has been following the footsteps of Arab Spring and can be noted as the extension of Arab Spring in Muslim World. The results of this struggle would define the fate of Post-Islamism in Pakistan. Has Jamaat-i-Islami got the potential to reform its agenda accordingly? This paper intends to study the Jamaat’s struggle and tries to predict Jamaat’s role in post-Islamism scenario. There is a clear distinction between the people of religion and the people following the popular materialistic westernized value system. This division is also evident in political parties. Pakistan has been ruled mostly by the secular parties and rulers. The inability to establish Islamic system by replacing the imperial system has created militancy and revolt which requires the establishment of a sound model Islamic based system in the country. The political parties of Pakistan could not device a modernize agenda, equally acceptable in modernized world and addressing the prevailing issues and also having the indigenous religious and cultural roots. The inability of Jamaat-i-Islami Pakistan to transform its agenda accordingly to serve the post-Islamism has made it irrelevant in Pakistan’s politics. Once Jamaat leaves behind its hard position as an Islamist party and accepts the post-Islamism as beginning to create its idealized state and society, it can pursue its agenda gradually. The phenomenon of post-Islamism does not make Islamists irrelevant but invites them to listen to the priorities of masses rather than insisting on the agenda of their respective ideologues to be followed for all times. The ruling Muslim democrats and military dictators of Pakistan have been following unfair means to sustain their political power which gave rise to space for the new political parties to emerge and organize agitation successfully in Pakistani Politics. Jamaat-i-Islami could not fill that space to be an agent of Post-Islamism and could not break their chains which had been tying them to the prevailing failed democracy of Pakistan. Post-Islamists are the addressers of the rulers corruption and are struggling for reforms in system. Jamaat due to its ideological compulsions could not transform its agenda accordingly. The new scenario indicates that the Post-Islamism which emerged in Arab World can be taken as first step to establish democracy and justice in state and society and then the establishment of Islamic law and the establishment of an Islamic state should have been the next targets. This gradual agenda would have delivered public support to the Jamaat which deserved that but PTI & PAT have cashed this opportunity in Pakistani politics by strengthening their respective vote banks.

Keywords: arab spring, islamic state, islamic political parties, muslim world, post-islamism

Procedia PDF Downloads 366
4328 Efficacy Study of Post-Tensioned I Girder Made of Ultra-High Performance Fiber Reinforced Concrete and Ordinary Concrete for IRC Loading

Authors: Ayush Satija, Ritu Raj

Abstract:

Escalating demand for elevated structures as a remedy for traffic congestion has led to a surge in the construction of viaducts and bridges predominantly employing prestressed beams. However, post-tensioned I-girder superstructures are gaining traction for their attributes like structural efficiency, cost-effectiveness, and easy construction. Recently, Ultra-high-performance fiber-reinforced concrete (UHPFRC) has emerged as a revolutionary material in reshaping conventional infrastructure engineering. UHPFRC offers exceptional properties including high compressive and tensile strength, alongside enhanced durability. Its adoption in bridges yields benefits, notably a remarkable strength-to-weight ratio enabling the design of lighter and slender structural elements, enhancing functionality and sustainability. Despite its myriad advantages, integration of UHPFRC in construction is still evolving, hindered by factors like cost, material availability, and design standardization. Consequently, there's a need to assess the feasibility of substituting ordinary concrete (OC) with UHPFRC in bridges, focusing on economic considerations. This research undertakes an efficacy study between post-tensioned I-girders fabricated from UHPFRC and OC, evaluating cost parameters associated with concrete production, reinforcement, and erection. The study reveals that UHPFRC becomes economically viable for spans exceeding 40.0m. This shift in cost-effectiveness is attributed to factors like reduced girder depth, elimination of un-tensioned steel, diminished need for shear reinforcement and decreased erection costs.

Keywords: post tensioned I girder, superstructure, ultra-high-performance fiber reinforced concrete, ordinary concrete

Procedia PDF Downloads 33
4327 Investigating the Efficacy of HIV/AIDS Psycho-Education and Behavioural Skills Training in Reducing Sexual Risk Behaviours in a Trucking Population in Nigeria

Authors: Abiodun Musbau Lawal, Benjamin Oladapo Olley

Abstract:

Long Distance Truck Drivers (LDTDs) have been found to be a high-risk group in the spread of HIV/AIDS globally; perhaps, due to their high Sexual Risk Behaviours (SRBs). Interventions for reducing SRBs in trucking population have not been fully exploited. A quasi-experimental control group pretest-posttest design was used to assess the efficacy of psycho-education and behavioural skills training in reducing SRBs among LDTDs. Sixteen drivers rivers were randomly assigned into either experimental or control groups using balloting technique. A questionnaire was used as an instrument for data collection. Repeated measures t-test and independent t-test were used to test hypotheses. The intervention had a significant effect on the SRBs among LDTDs at post-test(t{7}=6.01, p<.01) and at followup (t{7}=6.42, p<.01). No significant difference in sexual risk behaviour of LDTDs at post-test and at follow-up stage. Similarly, intervention had significant effects on sexual risk behaviour at post-test (t {14}=- 4.69, p<.05) and at follow-up (t {14}= -9.56, p < .05) respectively. At post-test and follow-up stages, drivers in experimental group reported reduced SRBs than those in the control group. Drivers in an experimental group reported lower sexual risk behaviour a week after intervention as well as at three months follow-up than those in the control group. It is concluded that HIV/AIDS preventive intervention that provides the necessary informational and behavioural skills content can significantly impact long distance truck drivers sexual risk behaviours.

Keywords: HIV/AIDS interventions, long distance truck drivers, Nigeria, sexual risk behaviours

Procedia PDF Downloads 473
4326 Measurement of Sarcopenia Associated with the Extent of Gastrointestinal Oncological Disease

Authors: Adrian Hang Yue Siu, Matthew Holyland, Sharon Carey, Daniel Steffens, Nabila Ansari, Cherry E. Koh

Abstract:

Introduction: Peritoneal malignancies are challenging cancers to manage. While cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) may offer a cure, it’s considered radical and morbid. Pre-emptive identification of deconditioned patients for optimization may mitigate the risks of surgery. However, the difficulty lies in the scarcity of validated predictive tools to identify high-risk patients. In recent times, there has been growing interest in sarcopenia, which can occur as a result of malnutrition and malignancies. Therefore, the purpose of this study was to assess the utility of sarcopenia in predicting post-operative outcomes. Methods: A single quaternary-center retrospective study of CRS and HIPEC patients between 2017-2020 was conducted to determine the association between pre-operative sarcopenia and post-operative outcomes. Lumbar CT images were analyzed using Slice-o-matic® to measure sarcopenia. Results : Cohort (n=94) analysis found that 40% had sarcopenia, with a majority being female (53.2%) and a mean age of 55 years. Sarcopenia was statistically associated with decreased weight compared to non-sarcopenia patients, 72.7kg vs. 82.2kg (p=0.014) and shorter overall survival, 1.4 years vs. 2.1 years (p=0.032). Post-operatively, patients with sarcopenia experienced more post-operative complications (p=0.001). Conclusion: Complex procedures often require optimization to prevent complications and improve survival. While patient biomarkers – BMI and weight – are used for optimization, this research advocates for the identification of sarcopenia status for pre-operative planning. Sarcopenia may be an indicator of advanced disease requiring further treatment and is an emerging area of research. Larger studies are required to confirm these findings and to assess the reversibility of sarcopenia after surgery.

Keywords: sarcopaenia, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, surgical oncology

Procedia PDF Downloads 78
4325 The Interventional, Prospective, Real-World Post-Marketing Clinical Follow-Up Trial of a Polycarbophil Vaginal Moisturising Gel in Women Affected by Vaginal Dryness in Late Menopausal Transition and Postmenopause: A Triple Investigation

Authors: A. Cagnacci, D. F. Barattini, E. Casolati, M. Mangrella, E. Piccolo, S. Rosu, L. C. Pătrașcu

Abstract:

This Triple study aimed to evaluate the efficacy of polycarbophil vaginal gel (PCV) in treating symptoms of vaginal atrophy (VA) in peri- and post-menopausal women. Women in peri- (n=29) and postmenopause (n=54) diagnosed with VA were progressively enrolled and treated once a day for 30 days. Thereafter, those wishing to continue (n=73) received the PCV treatment for an additional 180 days. The vaginal health index (VHI) and vaginal dryness, irritation, and pain at intercourse, along with treatment safety, were evaluated at baseline, 30 days of treatment, and after additional 180 days. At baseline, the VHI (p<0.056) and VAS of vaginal dryness (p=0.0001,) irritation (p=0.002), and pain at intercourse (p=0.0001) were worse in postmenopausal women than in perimenopausal women. VHI and VA symptoms improved in all women, and after 30 days of PCV administration, they were similar between peri-and postmenopausal women. After an additional 180 days of treatment, VHI further increased (p=0.0001), VAS of all symptoms (P=0.0001) and the Global Symptom Score (P=0.0001) further decreased. The treatment was safe. Treatment with PCV improves VA symptoms in both peri- and post-menopausal women. Prolongation of treatment up to 6 months increases the efficacy of treatment with no side effects.

Keywords: late menopausal transition, postmenopause, polycarbophil, sexuality, vaginal dryness

Procedia PDF Downloads 53
4324 Bilateral Thalamic Hypodense Lesions in Computing Tomography

Authors: Angelis P. Barlampas

Abstract:

Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

Procedia PDF Downloads 112
4323 Quantum Cryptography: Classical Cryptography Algorithms’ Vulnerability State as Quantum Computing Advances

Authors: Tydra Preyear, Victor Clincy

Abstract:

Quantum computing presents many computational advantages over classical computing methods due to the utilization of quantum mechanics. The capability of this computing infrastructure poses threats to standard cryptographic systems such as RSA and AES, which are designed for classical computing environments. This paper discusses the impact that quantum computing has on cryptography, while focusing on the evolution from classical cryptographic concepts to quantum and post-quantum cryptographic concepts. Standard Cryptography is essential for securing data by utilizing encryption and decryption methods, and these methods face vulnerability problems due to the advancement of quantum computing. In order to counter these vulnerabilities, the methods that are proposed are quantum cryptography and post-quantum cryptography. Quantum cryptography uses principles such as the uncertainty principle and photon polarization in order to provide secure data transmission. In addition, the concept of Quantum key distribution is introduced to ensure more secure communication channels by distributing cryptographic keys. There is the emergence of post-quantum cryptography which is used for improving cryptographic algorithms in order to be more secure from attacks by classical and quantum computers. Throughout this exploration, the paper mentions the critical role of the advancement of cryptographic methods to keep data integrity and privacy safe from quantum computing concepts. Future research directions that would be discussed would be more effective cryptographic methods through the advancement of technology.

Keywords: quantum computing, quantum cryptography, cryptography, data integrity and privacy

Procedia PDF Downloads 16
4322 The Safety Profile of Vilazodone: A Study on Post-Marketing Surveillance

Authors: Humraaz Kaja, Kofi Mensah, Frasia Oosthuizen

Abstract:

Background and Aim: Vilazodone was approved in 2011 as an antidepressant to treat the major depressive disorder. As a relatively new drug, it is not clear if all adverse effects have been identified. The aim of this study was to review the adverse effects reported to the WHO Programme for International Drug Monitoring (PIDM) in order to add to the knowledge about the safety profile and adverse effects caused by vilazodone. Method: Data on adverse effects reported for vilazodone was obtained from the database VigiAccess managed by PIDM. Data was extracted from VigiAccess using Excel® and analyzed using descriptive statistics. The data collected was compared to the patient information leaflet (PIL) of Viibryd® and the FDA documents to determine adverse drug reactions reported post-marketing. Results: A total of 9708 adverse events had been recorded on VigiAccess, of which 6054 were not recorded on the PIL and the FDA approval document. Most of the reports were received from the Americas and were for adult women aged 45-64 years (24%, n=1059). The highest number of adverse events reported were for psychiatric events (19%; n=1889), followed by gastro-intestinal effects (18%; n=1839). Specific psychiatric disorders recorded included anxiety (316), depression (208), hallucination (168) and agitation (142). The systematic review confirmed several psychiatric adverse effects associated with the use of vilazodone. The findings of this study suggested that these common psychiatric adverse effects associated with the use of vilazodone were not known during the time of FDA approval of the drug and is not currently recorded in the patient information leaflet (PIL). Conclusions: In summary, this study found several adverse drug reactions not recorded in documents emanating from clinical trials pre-marketing. This highlights the importance of continued post-marketing surveillance of a drug, as well as the need for further studies on the psychiatric adverse events associated with vilazodone in order to improve the safety profile.

Keywords: adverse drug reactions, pharmacovigilance, post-marketing surveillance, vilazodone

Procedia PDF Downloads 110
4321 Binocular Heterogeneity in Saccadic Suppression

Authors: Evgeny Kozubenko, Dmitry Shaposhnikov, Mikhail Petrushan

Abstract:

This work is focused on the study of the binocular characteristics of the phenomenon of perisaccadic suppression in humans when perceiving visual objects. This phenomenon manifests in a decrease in the subject's ability to perceive visual information during saccades, which play an important role in purpose-driven behavior and visual perception. It was shown that the impairment of perception of visual information in the post-saccadic time window is stronger (p < 0.05) in the ipsilateral eye (the eye towards which the saccade occurs). In addition, the observed heterogeneity of post-saccadic suppression in the contralateral and ipsilateral eyes may relate to depth perception. Taking the studied phenomenon into account is important when developing ergonomic control panels in modern operator systems.

Keywords: eye movement, natural vision, saccadic suppression, visual perception

Procedia PDF Downloads 150
4320 18F-Fluoro-Ethyl-Tyrosine-Positron Emission Tomography in Gliomas: Comparison with Magnetic Resonance Imaging and Computed Tomography

Authors: Habib Alah Dadgar, Nasim Norouzbeigi

Abstract:

The precise definition margin of high and low-grade gliomas is crucial for treatment. We aimed to assess the feasibility of assessment of the resection legions with post-operative positron emission tomography (PET) using [18F]O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET). Four patients with the suspicion of high and low-grade were enrolled. Patients underwent post-operative [18F]FET-PET, pre-operative magnetic resonance imaging (MRI) and CT for clinical evaluations. In our study, three patients had negative response to recurrence and progression and one patient indicated positive response after surgery. [18F]FET-PET revealed a legion of increased radiotracer uptake in the dura in the craniotomy site for patient 1. Corresponding to the patient history, the study was negative for recurrence of brain tumor. For patient 2, there was a lesion in the right parieto-temporal with slightly increased uptake in its posterior part with SUVmax = 3.79, so the study was negative for recurrence evaluation. In patient 3 there was no abnormal uptake with negative result for recurrence of brain tumor. Intense radiotracer uptake in the left parietal lobe where in the MRI there was a lesion with no change in enhancement in the post-contrast image is indicated in patient 4. Assessment of the resection legions in high and low-grade gliomas with [18F]FET-PET seems to be useful.

Keywords: FET-PET, CT, glioma, MRI

Procedia PDF Downloads 195
4319 The Applications of Group Counseling on Self-Concept, Depression, and Resilience of Teenage Pregnancy

Authors: Fauziah Mohd Sa’ad, Mohammad Aziz Shah, B. Mohammad Arip, Norazani Ahmad, Mohd Noor Idris, Hapsah M. Yusof

Abstract:

This study was carried out to assess the application of person-centred therapy and Cognitive Psychology Ad-Din group counseling on self-concept, depression, and resilience of teenage pregnancy. This study involved 55 teenage pregnancy at three women’s refuge centers which are from KEWAJA, Rhaidatus Sakinah, and Taman Seri Puteri Cheras (JKM). Subjects were classed into two treatment groups and one control group. The Multidimensional Self-Concept Scale (MSCS), Beck Depression inventory (BDI) and Adolescent Resiliency Attitude Scale (ARAS) was administered to assess self-concept, depression, and resilience of teenage pregnancy. The control pre and post test design was used for this study. The research data were analyzed using descriptive analysis, ANOVA, MANCOVA and Tuckey Post Hoc with the significant level of .01 and .05. All treatment group received group counseling sessions for 7 consecutive week, once in each week. The Person-centred group and Cognitive Psychology Ad-Din group counseling showed a significant reduction (pre-test to post-test) on depression, enhancing self-concept and resilience of teenage pregnancy.

Keywords: group counseling, person-centred therapy, cognitive psychology Ad-Din, teenage pregnancy

Procedia PDF Downloads 565
4318 Marketing Implications and the Dynamics of Changing Gender Roles in Families

Authors: Kehinde Emmanuel Atanlusi

Abstract:

It is impossible to stifle the gust of social change as it makes its way through institutionalised hierarchies on its way to expressing itself. This advancement might also have repercussions for institutions, families, and politics, so modifying the norms and establishing new societal ideals. In the following paragraphs, it will explore how gender roles in the family have changed over time, how this has affected consumption, and how marketing has been influenced by these changes. It was decided to use the empirical research method, which led to several discoveries, one of which was that marketing in the pre-modern era was predicated on metanarratives and gender stereotypes. However, these aspects of marketing have undergone significant transformations in the post-modern era, which led to the formation of an assumption regarding what future marketing trends will be like. In spite of the fact that post-modern marketing methods have a number of drawbacks, it was suggested that these strategies be embraced and updated in the future in order to expand consumer bases and target audiences.

Keywords: Marketing, Gender Roles, Advertising, Decentralisation, Fragmentation

Procedia PDF Downloads 112
4317 Innovation Management in State-Owned-Enterprises in the Digital Transformation: An Empirical Case Study of Swiss Post

Authors: Jiayun Shen, Lorenz Wyss, Thierry Golliard, Matthias Finger

Abstract:

Innovation is widely recognized as the key for private enterprises to win the market competition. The state-owned-enterprises need to be innovative to compete in the market after the privatization as well. However, it is a lack of research to study how state-owned-enterprises manage innovation to create new products and services. Swiss Post, a Swiss state-owned-enterprises, has established a department to transform the corporate culture and foster innovation to achieve digital transformation. This paper describes the innovation management process at the Swiss Post and analyzes the impacts of the instruments, the organizational structure, and explores the barriers of innovation. This study used qualitative methods based on a review of the literature on innovation management and semi-structured interviews. Being established for over five years, the Swiss Post’s innovation management department has established a software-assisted modularized platform with systematic instruments to help the internal employees with the different innovation processes. It guides the innovators from idea creation to piloting in markets and supports with a separate financing source, with knowledge inputs and coaching, as well as with connections to external partners through the open innovation and venturing team. The platform also adapts to different business units within the corporate with a customized tailor for the various operational business units. The separate financing instruments enabled the creation and further development of new ideas; the coaching services contribute greatly to the transformation of teams’ innovation culture by providing new knowledge, thinking methods, and use cases for inspiration. It also facilitates organizational learning to help the whole corporate with the digital transformation. However, it is also confronted with a big challenge in twofold. Internally, the disruptive projects often hardly overcome the obstacles of long-established operational processes in the traditional business units; externally, the expectations of the public and restrictions from the federal government have become high hurdles for the company to stay and compete in the innovation track.

Keywords: empirical case study, innovation management, state-owned-enterprise, Swiss Post

Procedia PDF Downloads 118
4316 Emerging Methods as a Tool for Obtaining Subconscious Feedback in E-Commerce and Marketplace

Authors: J. Berčík, A. Mravcová, A. Rusková, P. Jurčišin, R. Virágh

Abstract:

The online world is changing every day. With this comes the emergence and development of new business models. One of them is the sale of several types of products in one place. This type of sales in the form of online marketplaces has undergone a positive development in recent years and represents a kind of alternative to brick-and-mortar shopping centres. The main philosophy is to buy several products under one roof. Examples of popular e-commerce marketplaces are Amazon, eBay, and Allegro. Their share of total e-commerce turnover is expected to even double in the coming years. The paper highlights possibilities for testing web applications and online marketplace using emerging methods like stationary eye cameras (eye tracking) and facial analysis (FaceReading).

Keywords: emerging methods, consumer neuroscience, e-commerce, marketplace, user experience, user interface

Procedia PDF Downloads 69
4315 Pulmonary Complication of Chronic Liver Disease and the Challenges Identifying and Managing Three Patients

Authors: Aidan Ryan, Nahima Miah, Sahaj Kaur, Imogen Sutherland, Mohamed Saleh

Abstract:

Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes.

Keywords: dyspnea, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary syndrome

Procedia PDF Downloads 118