Search results for: birth trauma

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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Authors: Lola Vivour-Adeniyi, Oluwatoyosi Abikoye

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Domestic and sexual violence inflicts profound trauma on individuals, with particularly distressing consequences for young people when experienced in familiar settings such as homes, schools, religious institutions, or with trusted individuals. Research conducted at the Lagos State Domestic and Sexual Violence Agency (DSVA) from 2015 to 2023 reveals a disconcerting trend where young people often misconstrue abusive actions as tolerable, partially acceptable, or merely morally wrong due to a lack of awareness about their rights as guaranteed under the Lagos State Child’s Right Law. This paper delves into the grassroots initiatives of the Lagos State DSVA, specifically the Kings and Queens Club, designed to combat domestic and sexual violence (DSV) among teens. The club focuses on raising awareness and ensuring access to support services. The paper provides a concise analysis of the club's impact, contextualizing Lagos State's efforts to eradicate DSV for future generations. Additionally, it comprehensively examines the legal rights of children and young persons as outlined in the Lagos State Child’s Right Law 2007, Protection Against Domestic Violence Law 2007, Criminal Law 2011, and Domestic and Sexual Violence Agency Law 2021. In conclusion, this paper aims to inform policy and community development initiatives, emphasizing the effectiveness of school-based approaches in creating a sustainably equitable society for children and young persons.

Keywords: school-based approach, domestic and sexual violence, Lagos state child’s rights law, Lagos state DSVA

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Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: Hester Fass, Ofir Pinto

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Research indicates gaps in education, employment rates and wages between people with disabilities and those without disabilities. One of the main tools available to reduce these gaps is vocational rehabilitation. In order to examine the effects of vocational rehabilitation, a follow-up study, based on comprehensive administrative data, was conducted. The study included 88,286 people with disabilities who participated in vocational rehabilitation of the National Insurance Institute of Israel (NII), and completed the process between 1999 and 2012. Research variables included: employment rates, job persistence and wage levels. This research, the first of its kind in Israel, has several unique aspects: a)a long-range follow-up study on people who completed vocational rehabilitation; b) examination of a broad population spectrum, including also people that are not eligible to disability pensions ; c) a comparison among those with work-related injuries, those injured in hostile acts and those injured in other circumstances; and finally d) the identification of the characteristics of those who are entitled to vocational rehabilitation but who do not participate in any vocational rehabilitation plan. The most notable results include: 1. Vocational rehabilitation contributed to employment, job persistence and wage levels. Participation in vocational rehabilitation resulted in an employment rate of 65% within two years after completing the program, and 73% eventually. Participation in a vocational rehabilitation plan also contributed to job persistence and wage levels. 2. Vocational rehabilitation plans aimed at integration in universal frameworks increased the chances of being employed, persisting at the job and receiving a higher wage than did the vocational rehabilitation aimed at selective frameworks (such as sheltered workshops). 3. The type of disability affected the chances of integration in a vocational rehabilitation plan and in the labor market. People with a disability from birth had greater chances of integration in a vocational rehabilitation plan, while the type of disability and its severity affected the chances of the person with disabilities to find employment.

Keywords: vocational rehabilitation, employment, job persistence, wages

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Authors: Andriana Purnama, Reno Rudiman, Kezia Christy

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Anal stenosis which develops due to anoderm scarring usually caused by secondary to surgical trauma, has become common, causing significant decrease patient’s quality of life. Even though mild anal stenosis was treated with non-surgical treatment, but surgical reconstruction in unavoidable for moderate to severe anal stenosis that cause distressing, severe anal pain and inability to defecate. In our study, we intend to share our result with the use of diamond flap in treatment of anal stenosis. This case report illustrates a 57-year-old male patient who presented with difficulty and discomfort in defecation caused by anal stenosis after 2 years of open hemorrhoidectomy surgery. At physical examination, there was requirement of forceful dilatation when the index finger was inserted or precisely 6mm as measured by hegar dilator (moderate anal stenosis). Blood test result was within normal limits. The patient underwent anal repair and diamond flap where the scar tissue at 6 and 9 o’clock directions was excised and diamond graft was incised carefully while paying attention to the vascular supply. Finally, the graft was fixated without any tension to the anal canal, resulting in diameter of 2 cm after operation. After 2 days post operation, the patient was in stable condition, without any complication, and discharged. There was no abnormality concerning the stool. Ten days after the operation, diamond flap was in normal condition and without any complication. He was scheduled for futher follow up at the Digestive Surgery Department. Anal stenosis due to overzealous hemorrhoidectomy is a complication that is preventable when performed in experienced hands. Diamond flap was one of the options for the anal stenosis treatment with less complication.

Keywords: anal stenosis, diamond flap, post hemorrhoidectomy, anal repair

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

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Introduction: Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular malformation. It most often appears at birth or during the first days of life. Its origin is still unknown. It associates a livedo with telangiectasias of diffuse or segmental topography. In rare cases, it can be associated with neurological disorders such as macrocephaly and, less frequently, with epilepsy. Methodology: We report a case of an infant with Macrocephaly- Cutis marmorata telangiectatica congenita syndrome associated with epilepsy. Results: This is the case of a one month and 15 days old female infant from a non-consanguineous marriage, admitted for a status epilepticus in the context of apyrexia. Infectious and metabolic causes had been eliminated. Physical examination had shown non-infiltrated and reticular livedoid erythematous patches affecting the left upper limb and atrophic on the back of the left hand. Cerebral magnetic resonance imaging (MRI) showed thin layers of bifrontal, temporal, and left parietal hygromas associated with the widening of the bifrontal subarachnoid spaces. The electroencephalogram showed a well-organized sleep tracing with a single right occipital paroxysmal abnormality. Antiepileptic treatment has been administered with good clinical evolution and regression of the skin lesion and a control electroencephalogram without abnormality. Conclusion: This observation illustrates an association of CMTC with both macrocephaly and epilepsy. This pathology, which is relatively benign and has a good prognosis, generally does not require treatment. However, a detailed examination must be carried out, and a follow-up plan must be put in place for each patient presenting with CMTC, given the risk of association with other abnormalities, which can be potentially serious.

Keywords: cutis marmorata telangiectatica congenita, macrocephaly, epilepsy, children

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Authors: Walter Rafael Ramos Villanueva

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The overwhelming majority of scholarship on David Chariandy’s novel Soucouyant focuses on how Adele’s dementia represents the preservation of “cultural memory” and the perniciousness of “historical trauma.” However, by metaphorizing Adele’s mental condition, these critics risk treating her dementia as mostly figurative, and they thus elide a more detailed discussion of the literal ramifications of her dementia diagnosis. To move beyond these readings, then, my paper will approach Adele’s disorder as a literal medical condition and explore how her caregiving needs affect not only her but also those around her. Soucouyant subverts traditional caregiving narratives by depicting the difficult and typically invisible labour of informal caregiving that is undertaken by the families and friends of those who are ill or otherwise disabled. Because Adele’s family is unable to access proper public healthcare resources within the community, the burden of care falls upon the protagonist and his brother, who become “parentified children.” Parentified children, according to Nancy D. Chase, are “parents to their parents, and fulfill this role at the expense of their own developmentally appropriate needs and pursuits.” The novel provides a depiction of informal caregiving that is multi-faceted and asks us to question why is it exactly that we place the burden of care on those who are not equipped to handle such pressures instead of putting the onus on the government and the public healthcare system to take care of its most vulnerable members. Ageing Studies scholar Larry Polvika notes that although policymakers often offer “pious expressions of appreciation” and acknowledge that informal caregiving is “the backbone of our long-term care system,” governmental support for these caregivers remains inadequate. It is my belief that, by showcasing the struggles of informal caregivers, Chariandy’s text combats this dangerous and empty political rhetoric.

Keywords: caregiving, dementia, literature, parentified children

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Authors: Ubaid Ur Rahman, Waqar Younas, Sooraj Kumar Chhabira

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Environmentally sustainable building construction has experienced significant growth during the past 10 years at international level. This paper shows that the conceptual framework adopts sustainability techniques in construction to develop environment friendly building called green building. Waste occurs during the different construction phases which causes the environmental problems like, deposition of waste on ground surface creates major problems such as bad smell. It also gives birth to different health diseases and produces toxic waste agent which is specifically responsible for making soil infertile. Old recycled building material is used in the construction of new building. Sustainable construction is economical and saves energy sources. Sustainable construction is the major responsibility of designer and project manager. The designer has to fulfil the client demands while keeping the design environment friendly. Project manager has to deliver and execute sustainable construction according to sustainable design. Steel is the most appropriate sustainable construction material. It is more durable and easily recyclable. Steel occupies less area and has more tensile and compressive strength than concrete, making it a better option for sustainable construction as compared to other building materials. New technology like green roof has made the environment pleasant, and has reduced the construction cost. It minimizes economic, social and environmental issues. This paper presents an overview of research related to the material use of green building and by using this research recommendation are made which can be followed in the construction industry. In this paper, we go through detailed analysis on construction material. By making suitable adjustments to project management practices it is shown that a green building improves the cost efficiency of the project, makes it environmental friendly and also meets future generation demands.

Keywords: sustainable construction, green building, recycled waste material, environment

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Authors: Nita Nurlaila Kadarwaty

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Purpose: This study presents a rare case of bilateral Acute Primary Angle Closure Glaucoma (PACG). Method: A case report of a 64-year-old woman with a good outcome Acute PACG in both eyes who underwent phacotrabeculectomy surgery. Result: A 64-year-old woman complained of acute pain in both eyes, accompanied by decreased vision, photophobia, and seeing halos for three weeks. There was no history of trauma, steroid or other systemic drugs used, or intraocular surgery before. Ophthalmologic examination revealed a right eye (RE) visual acuity of 0.1, left eye (LE) 0.2. RE intraocular pressure (IOP) was 12 mmhg and LE: 36.4 mmHg in medication of timolol maleat ED and acetazolamide oral. Both eyes' anterior segments revealed mixed injection, corneal edema, shallow anterior chamber, posterior synechiae, mid-dilatation pupil with negative pupillary reflection, and cloudy lens without intumescent. There was a glaucomatous optic and closed iridocorneal angle on the gonioscopy. Initial treatments included oral acetazolamide and potassium aspartate 250 mg three times a day, timolol maleate ED 0.5% twice a day, and prednisolone acetate ED 1% four times a day. This patient underwent trabeculectomy, phacoemulsification, and implantation of IOL in both eyes. One week after the surgeries, both eyes showed decreased IOP and good visual improvement. Conclusion: Bilateral simultaneous Acute PACG is generally severe and results in a poor outcome. It causes rapidly progressive visual loss and is often irreversible. Phacotrabeculectomy has more benefits compared to only phacoemulsification for the intervention regarding the reduced IOP post-surgical.

Keywords: acute primary angle closure glaucoma, intraocular pressure, phacotrabeculectomy, glaucoma

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Authors: Sabina Garayeva

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To determine the significant risk factors for intrauterine growth restriction (IUGR), we carried out a thorough study of the social status of the parents of children with IUGR. We observed 315 mothers who gave birth to children with (IUGR), of which 172 mothers with asymmetric type and 143 mothers with symmetric type of IUGR. Through a detailed survey was gathered detailed information about education of parents. The results show that the majority of mothers with IUGR had secondary education (44,8 ± 2,8%), and fathers - higher education (35,2 ± 2,7%). Whereas in the control group, the largest number of parents had higher education (mother 35,3 ± 4,4%, fathers 42,9 ± 4,5%). Number of mothers with secondary education with IUGR was significantly (p1 <0,01; χ2 = 22,67) differs from the number of mothers with physiological pregnancy with the same level of education. Meanwhile, in the group with a symmetrical embodiment of IUGR mothers with secondary formation of significantly greater 53,1 ± 4,2%, than the asymmetric embodiment IUGR 37,8 ± 3,7% (p2 <0,05; χ2 = 8 06). Among fathers with secondary education significant difference was noted in the symmetric version of IUGR 37,8 ± 4,1% more than in the control group (p1 <0,05), and among parents of children with asymmetric IUGR option prevailed fathers with higher education - 37 2 ± 3,7%. Thus, our results revealed a low educational level of the mother as a risk factor for IUGR, which further help to develop preventive and therapeutic measures to eliminate the severity of its consequences. As seen from the data presented, mothers of children with asymmetric IUGR had a school education and fathers - higher education, while in the symmetric type of both parents had secondary education. It is found that frequency of children, born with IUGR, of mothers - housewives and fathers, engage in physical labor, was high. Thus, the analysis conducted by the social status of the parents with IUGR revealed a low level of education and unemployed mothers as risk factors for this disease, which in the future will help to develop preventive and therapeutic measures to eliminate the severity of its.

Keywords: intrauterine growth restriction, education of mothers, education influence, IUGR

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Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

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Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

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Authors: R. Botrugno, S Basyuni, G. Nugent, I. Jenkyn, A. Ferro, H. Bennett, C. Hjalmarsson, J. Chu, V. Santhanam

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This trainee led randomised controlled trial (RCT) aims to assess various outcomes for resorbable versus non-resorbable sutures for traumatic lacerations to the face. Within this trial of resorbable versus non-resorbable sutures for traumatic lacerations of the face (TORNFace), patient recruitment was facilitated by trainees who were employed at an NHS University Teaching Hospital in the United Kingdom. The trainees received appropriate training prior to recruiting patients for the trial. This included the completion of a national research e-learning module and face-to-face training that was provided locally. The locally delivered training provided an understanding of the eligibility criteria for the trial and the consent process. Existing trainee skills were utilised involving clinical photography to record baseline data and delivering the intervention based on the treatment arm selected. Eligible patients who required primary closure of traumatic lacerations of the face were randomised into one of two treatment arms. These comprised of resorbable (vicryl rapide) or non-resorbable sutures (ethilon). Primarily the cosmetic outcome was assessed. Secondary outcomes included: complications rates, health care economics, and patient-reported outcomes. Remote follow-up of recruited patients utilised photographs of the facial laceration which had received the intervention. These took place at 1 week, 3 months and 6 months post-intervention. This study aims to demonstrate an example of trainee-led research within the specialty of oral and maxillofacial surgery. The available data for the randomised controlled trial will also be presented.

Keywords: laceration, suture, trauma, trial

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Authors: Yijie Wang, Hanwei Cheng

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Under the Chinese educational context, the materials for patriotic education typically take the form of grand narratives. However, in post-modern times the younger members of society tend to welcome elements of more micro and personal nature. It is therefore important to explore how patriotism can be integrated into an ‘everyday’, private narrative that holds more attraction for the young. Based on semi-structured interviews of eight Chinese graduate students, this research examines how Chinese young people draw materials to establish national identity and develop love for the country from everyday-life details, as well as how they perceive, interpret and articulate their patriotism through private narratives. And implications for patriotic education are proposed accordingly. Several conclusions are drawn from the pre-interviews. Firstly, sensory experiences that remind people of their country—such as the taste of Chinese delicacies and the sound of a traditional instrument—are a major source of patriotic feelings. Secondly, the love for the country often stems from and is continued to be mediated by the emotional attachment with other people, typically significant others, and patriotism is articulated (or acknowledged) by the young as a kind of ‘sentiment’ rather than ‘faith’ or ‘belief’. Thirdly, for young people who are currently studying abroad, their birth country represents a kind of familiar, well-accustomed life or lifestyle, and any nostalgic realization of it leads to increased national belonging and sense of identity. Fourthly, the awareness of the country’s transformations—positive ones and neutral ones alike—triggers young people affections towards the country, and even negative transformations may result in promoted sense of self-involvement and therefore consolidate national identity. Implications for patriotic education can be drawn accordingly, and although the research is conducted under the Chinese context, it will hopefully contribute to the understanding of relevant fields.

Keywords: national identity, patriotic education, private narrative, young people

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Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Background and aims: While in Western countries, unilateral spinal anesthesia has been widely practiced for a long time, it remains little known in the local anesthesia community, and has not been the object of many studies. However, it is a simple, practical and effective technique. Our objective was to evaluate this practice in emergency anesthesia management in frail patients and to compare it with conventional spinal anesthesia. Methods: This is a prospective, observational, comparative study between hypobaric unilateral and conventional spinal anaesthesia for hip fracture surgery carried out in the operating room of the university military hospital of Staoueli. The work was spread over of 12-month period from 2019 to 2020. The parameters analyzed were hemodynamic variations, vasopressor use, block efficiency, postoperative adverse events, and postoperative morphine consumption. Results: -75 cases (mean age 72±14 years) -Group1= 41 patients (54.6%) divided into (ASA1=14.6% ASA2=60.98% ASA3=24.39%) single shoot spinal anaesthesia -Group2= 34 patients (45.3%) divided into (ASA1=2.9%, ASA2=26.4% ASA3=61.7%, ASA4=8.8%) unilateral hypobaric spinal anesthesia. -Hemodynamic variations were more severe in group 1 (51% hypotension) compared to 30% in group 2 RR=1.69 and odds ratio=2.4 -these variations were more marked in the ASA3 subgroup (group 1=70% hypotension versus group 2=30%) with an RR=2.33 and an odds ratio=5.44 -39% of group 1 required vasoactive drugs (15mg +/- 11) versus 32% of group 2 (8mg+/- 6.49) - no difference in the use of morphine in post-op. Conclusions: Within the limits of the population studied, this work demonstrates the clinical value of unilateral spinal anesthesia in ortho-trauma surgery in the frail patient.

Keywords: spinal anaesthesia, vasopressor, morphine, hypobaric unilateral spinal anesthesia, ropivacaine, hip surgery, eldery, hemodynamic

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Authors: Gianluca Del Rossi

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Sub-concussive impacts occur frequently in collision sports such as American tackle football. Sub-concussive level impacts are defined as hits to the head that do not result in the clinical manifestation of concussion injury. Presently, there is limited information known about the short-term effects of repeated sub-concussive blows to the head. Therefore, the purpose of this investigation was to determine if standard clinical measures could detect acute impairments in neurologic function resulting from the accumulation of sub-concussive impacts throughout a season of high school American tackle football. Simple reaction time using the ruler-drop test, and oculomotor performance using the King-Devick (KD) test, were assessed in 15 athletes prior to the start of the athletic season, then repeated each week of the season, and once following its completion. The mean reaction times and fastest KD scores that were recorded or calculated from each study participant and from each test session were analyzed to assess for change in reaction time and oculomotor performance over the course of the American tackle football season. Analyses of KD data revealed improvements in oculomotor performance from baseline measurements (i.e., decreased time), with most weekly comparisons to baseline being significantly different. Statistical tests performed on the mean reaction times obtained via the ruler-drop test throughout the season revealed statistically significant declines (i.e., increased time) between baseline and weeks 3, 4, 10, and 12 of the athletic season. The inconsistent and contrasting findings between KD data and reaction time demonstrate the need to identify more robust clinical measures to definitively assess if repeated sub-concussive impacts to the head are acutely detrimental to patients.

Keywords: head injury, mTBI and sport, subclinical head trauma, sub-concussive impacts

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Authors: Eda Jazexhiu-Postoli, Gladiola Hoxha, Ada Simeoni, Sonila Biba

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Background Neonatal hypotonia represents a commonly encountered issue in the Neonatal Intensive Care Unit and newborn nursery. The differential diagnosis is broad, encompassing chromosome abnormalities, primary muscular dystrophies, neuropathies and inborn errors of metabolism. Aim of study Our study describes some of the main clinical features of hypotonia in newborns and presents clinical cases of neonatal hypotonia we treated in our Neonatal unit in the last 3 years. Case reports Four neonates born in our hospital presented with hypotonia after birth, one preterm newborn 35-36 weeks of gestational age and three other term newborns (38-39 weeks of gestational age). Prenatal data revealed a decrease in fetal movements in both cases. Intrapartum meconium-stained amniotic fluid was found in 75% of our hypotonic newborns. Clinical features included inability to establish effective respiratory movements and need for resuscitation in the delivery room, respiratory distress syndrome, feeding difficulties and need for oro-gastric tube feeding, dysmorphic features, hoarse voice and moderate to severe muscular hypotonia. The genetic workup revealed the diagnosis of Autosomal Recessive Congenital Myasthenic Syndrome 1-B, Sotos Syndrome, Spinal Muscular Atrophy Type 1 and Transient Hypotonia of the Newborn. Two out of four hypotonic neonates were transferred to the Pediatric Intensive Care Unit and died at the age of three to five months old. Conclusion Hypotonia is a concerning finding in neonatal care and it is suggested by decreased intrauterine fetal movements, failure to establish first breaths, respiratory distress and feeding difficulties in the neonate. Prognosis is determined by its etiology and time of diagnosis and intervention.

Keywords: hypotonic neonate, respiratory distress, feeding difficulties, fetal movements

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Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Dumith Kulasekara

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This paper examines the representation of the body that particularly stresses the anatomical organs and the psychic conditions in contemporary art. The paper looks closely at the works that address personal and social meanings implying psychic conditions by bringing the internal hidden anatomical organs of the body to the surface of the visual language. The paper argues that contemporary artists conceptualize the idea of the body as a site of generating psychic conditions by excavating the body as material, subject, and object in art practice. The paper conceptualizes this excavating process of the body acts similarly to the idea of dissecting the corporeal body to understand its internal organism that again shapes the materiality of the surface of the body. In doing so, the paper brings together this argument, knowledge produced in the historical and contemporary anatomical education in art and science, and psychoanalytical approaches to the theme to develop new interpretations of representing psyche in the anatomical-bodied. The present paper defines this new form of body conceptually and materially addresses the issues related to psychic conditions: sexual desires, gender, traumas, and memories. The paper suggests that representation of the anatomical-bodied brings a new direction of the multidisciplinary approach introduced by artists to visualize the body and psyche in the contemporary context. The paper also presents an in-depth- discussion on technological, scientific, and philosophical knowledge employed in representing the idea of the body in addressing different psychic conditions to challenge the experiencing the body in contemporary art. Therefore, the paper focuses on examining the theme in the different forms of visual language and contexts in contemporary art. Finally, this research aims to offer a theoretical and conceptual background to curate an exhibition on the title of the anatomical-bodied and psyche in contemporary art with the body of work discussed in this paper.

Keywords: anatomy, body, contemporary art, psyche, psychoanalysis, representation, trauma

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Authors: Chernet Mulugeta, Girma Seyoum, Yeshineh Demrew, Kehabtimer Shiferaw

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Background: Obstetric fistula (OF) is a serious medical condition that includes an abnormal opening between the vagina and bladder (vesico-vaginal fistula) or the vagina and rectum (recto-vaginal fistula). It is usually caused by prolonged obstructed labour. Despite its serious health and psychosocial consequences, there is a paucity of evidence regarding the time it takes to heal from OF. Objective: The aim of this study was to assess the time to cure from obstetric fistula and its predictors among women admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Methodology: An institution-based retrospective cohort study was conducted from January 2015 to December 2020 among a randomly selected 434 women with OF in Addis Ababa Hamlin Fistula Hospital. Data was collected using a structured checklist adapted from a similar study. The open data kit (ODK) collected data was exported and analyzed by using STATA (14.2). Kaplan Meir was used to compare the recovery time from OF. To identify the predictors of OF, a Cox regression model was fitted, and an adjusted hazard ratio with a 95% confidence interval was used to estimate the strength of the associations. Results: The average time to recover from obstetric fistula was 3.95 (95% CI: 3.0-4.6) weeks. About ¾ of the women [72.8% (95% CI - 0.65-1.2)] were physically cured of obstetric fistula. Having secondary education and above [AHR=3.52; 95% CI (1.98, 6.25)] compared to no formal education, having a live birth [AHR=1.64; 95% CI (1.22, 2.21)], having an intact bladder [AHR=2.47; 95% CI (1.1, 5.54)] compared to totally destructed, and having a grade 1 fistula [AHR=1.98; 95% CI (1.19, 3.31)] compared to grade 3 were the significant predictors of shorter time to cure from an obstetric fistula. Conclusion and recommendation: Overall, the proportion of women with OF who were not being cured was unacceptably high. The time it takes for them to recover from the fistula was also extended. It connotes us to work on the identified predictors to improve the time to recovery from OF.

Keywords: time to recovery, obstetric fistula, predictors, Ethiopia

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Authors: Abolade Olajoke, Adigun Folasade Oyenike, Odunjo Oluronke Omolola Olaleye, Babajide Rotimi

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Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%). Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment. Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%) Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment.

Keywords: new town, urbanization, infrastructure boundary

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Authors: Joyce Fernandez

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This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

Procedia PDF Downloads 283

Authors: Ashmita Mukherjee, Yogesh Harishchandra Kabutare, Suritra Bandyopadhyay, Paulomi Ghosh

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Uncontrolled bleeding in the battlefield and the operation rooms can lead to serious injuries, trauma and even be lethal. Keratin was reported to be a haemostatic material which rapidly activates thrombin followed by activation of fibrinogen leading to the formation of insoluble fibrin. Also platelets, the main initiator of haemostasis are reported to adhere to keratin. However, the major limitation of pure keratin as a biomaterial is its poor physical property and corresponding low mechanical strength. To overcome this problem, keratin was cross-linked with alginate to increase its mechanical stability. In our study, Keratin extracted from feather waste showed yield of 80.5% and protein content of 8.05 ± 0.43 mg/mL (n=3). FTIR and CD spectroscopy confirmed the presence of the essential functional groups and preservation of the secondary structures of keratin. The keratin was then cross-linked with alginate to make a dope. The dope was used to draw fibers of desired diameters in a suitable coagulation bath using a customized wet spinning setup. The resultant morphology of keratin fibers was observed under a brightfield microscope. The FT-IR analysis implied that there was a presence of both keratin and alginate peaks in the fibers. The cross-linking was confirmed in the keratin alginate fibers by a shift of the amide A and amide B peaks towards the right and disappearance of the peak for N-H stretching (1534.68 cm-1). Blood was drawn in citrate vacutainers for whole blood clotting test and blood clotting kinetics, which showed that the keratin fibers could accelerate blood coagulation compared to that of alginate fibers and tissue culture plate. Additionally, cross-linked keratin-alginate fiber was found to have lower haemolytic potential compared to alginate fiber. Thus, keratin cross-linked fibers can have potential applications to combat unrestrained bleeding.

Keywords: biomaterial, biowaste, fiber, keratin

Procedia PDF Downloads 169

Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih

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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.

Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity

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Authors: Vidhi Chandra, Arshpreet Singh Grewal

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A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

Procedia PDF Downloads 89

Authors: Peeranan Wisanskoonwong, Sumitta Sawangtook

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Practicum in Midwifery II is the subject that affects most students to be stressed and anxious because they lack of experiences and self-confidence in delivery baby. This study is a qualitative research. That research objectives were (1) to study learning through reflective practice of nursing students (2) to explain the effects of learning through reflective practice of nursing students in the delivery room. The selected key informant method was criterion-based selection. Thirty-two of fourth-year nursing students in Kuakarun Faculty of nursing who practiced in Delivery room at Taksin Hospital in academic year 2014 were selected. Data collection was data triangulation which consisted of in-depth interview, group discussion and reading students’ reflective practice journal. The research instruments were students’ reflective practice journal, semi-structured questionnaires for in-depth interview, group discussion. Data analysis was thematic analysis. The research result found that: The learning method through reflective practice of nursing students in the delivery room were (1) reflective practice journal (2) dialogue (3) critical thinking and problem solving (4) incident analysis (5) self-criticism (6) observation and evaluation of practice. There were eight issues that students learned through their reflective practice were that (1) students' ethics and morality. (2) students' knowledge and comprehension (3) creative thinking of students (4) communications and collaboration (5) experiential learning of students (6) students’memories and impressions (7) students’experience in delivery baby (8) self-learning of students. Learning through reflective practice supported students’ awareness in improving knowledge and learning continuously and systematically. It helped to adjust the attitude to learning and leadership to be careful which help develop their skills, including critical thinking and understand themselves and understand others. Recommendation for applying research results: midwifery and nursing lecturers can apply these results to be a guide for development their clinical teaching in delivery rooms and other wards.

Keywords: learning, reflection, birth, qualitative research

Procedia PDF Downloads 267

Authors: Xiao-Yin Liu, Liang-Xue Zhou

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Traumatic brain injury (TBI), as a kind of nerve trauma caused by an external force, affects people all over the world and is a global public health problem. Although there are various clinical treatments for brain injury, including surgery, drug therapy, and rehabilitation therapy, the therapeutic effect is very limited. To improve the therapeutic effect of TBI, scaffolds combined with exosomes are a promising but challenging method for TBI repair. In this study, we examined whether a novel 3D-printed collagen/chitosan scaffold/exosomes derived from neural stem cells (NSCs) pretreated with insulin growth factor-1 (IGF-I) scaffolds (3D-CC-INExos) could be used to improve TBI repair and functional recovery after TBI. Our results showed that composite scaffolds of collagen-, chitosan- and exosomes derived from NSCs pretreated with IGF-I (INExos) could continuously release the exosomes for two weeks. In the rat TBI model, 3D-CC-INExos scaffold transplantation significantly improved motor and cognitive function after TBI, as assessed by the Morris water maze test and modified neurological severity scores. In addition, immunofluorescence staining and transmission electron microscopy showed that the recovery of damaged nerve tissue in the injured area was significantly improved by 3D-CC-INExos implantation. In conclusion, our data suggest that 3D-CC-INExos might provide a potential strategy for the treatment of TBI and lay a solid foundation for clinical translation.

Keywords: traumatic brain injury, exosomes, insulin growth factor-1, neural stem cells, collagen, chitosan, 3D printing, neural regeneration, angiogenesis, functional recovery

Procedia PDF Downloads 63

Authors: Isaac Kofi Mensah

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E-government has been adopted and used by many governments/countries around the world including Ghana to provide citizens and businesses with more accurate, real-time, and high quality services and information. The objective of this paper is to present an overview of the Government of Ghana’s (GoG) adoption and implement of e-government and its usage by the Ministries, Departments and its agencies (MDAs) as well as other public sector institutions to deliver efficient public service to the general public i.e. citizens, business etc. Government implementation of e-government focused on facilitating effective delivery of government service to the public and ultimately to provide efficient government-wide electronic means of sharing information and knowledge through a network infrastructure developed to connect all major towns and cities, Ministries, Departments and Agencies and other public sector organizations in Ghana. One aim for the Government of Ghana use of ICT in public administration is to improve productivity in government administration and service by facilitating the exchange of information to enable better interaction and coordination of work among MDAs, citizens and private businesses. The study was prepared using secondary sources of data from government policy documents, national and international published reports, journal articles, and web sources. This study indicates that through the e-government initiative, currently citizens and businesses can access and pay for services such as renewal of driving license, business registration, payment of taxes, acquisition of marriage and birth certificates as well as application for passport through the GoG electronic service (eservice) and electronic payment (epay) portal. Further, this study shows that there is an enormous commitment from GoG to adopt and implement e-government as a tool not only to transform the business of government but also to bring efficiency in public services delivered by the MDAs. To ascertain this, a further study need to be carried out to determine if the use of e-government has brought about the anticipated improvements and efficiency in service delivery of MDAs and other state institutions in Ghana.

Keywords: electronic government, electronic services, electronic pay, MDAs

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Authors: M. C. Muya, L. J. Erasmus

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Twenty four new born male Holstein calves were divided into two treatments groups and used to evaluate the effects of M. elsdenii NCIMB 41125. The first groups were dosed with 50 ml containing 108 CFU/mL of M. elsdenii NCIMB 41125 (Me) and the control calves were not dosed. Within each of the two treatments groups, calves were divided into three treatment groups (Not dosed: 7 d, 14 d and 21 d vs dosed Me 7 d, Me14 and Me21 d (treatments), each groups contained 4 calves within which two calves were euthanized at 24 h and two calves at 72 h. Calves entered the trial until euthanize at whether 24 or 72 H after dosing time. After receiving colostrum for 3 consecutive days after birth, calves were fed whole milk and had free access to a commercial calf starter pellet and fresh water. Fecal grab samples were taken from each calf in duplicate +24 h or +72 h relative to dosing. Immediately after euthanizing, the digestive tract was harvested, and duplicate rumen and colon digesta samples collected for VFA’s determination and DNA extraction for bacteria count using 16s RNA PCR probe technique. Independent two t-test was performed to compare mean volatile fatty acids. Mixed-effects linear regressions were performed to establish relationships between: 1) M. elsdenii and Me, and between VFA’s and Me using SAS (2009). M. elsdenii NCIMB 41125 was detected in the faeces, colon and rumen of dosed calves at both +24H and +72H and ranged from 1.6 x 106 to 4.9 x 109 cfu/ml, indicating its potential to colonize in the digestive tract of calves. There was a strong positive relationship (R²=0.96; P < 0.0001) between M. elsdenii NCIMB 41125 and M. elsdenii population (cfu/ml) in the rumen, suggesting that the increase in M. elsdenii was due to increased M. elsdenii NCIMB 41125. An increase in butyrate was observed from +24 h to +72 h when calves were dosed on both d 7 and 14. Results showed that Me presented a positive relationship with butyrate (P < 0.001, R² = 0.43) and a concomitant negative relationship with acetate (P = 0.017, R² = -0.33). These results suggest that dosing pre-weaned dairy calves with M. elsdenii NCIMB 41125 has the potential to alter ruminal VFA production through increasing proportions of butyrate at the expense of propionate.

Keywords: calves, megasphaera elsdenii, rumen fermentation, bacteria

Procedia PDF Downloads 376