Search results for: forensic cases
3883 Displaced People in International Marriage Law: Choice of Law and the 1951 Convention Relating to the Status of Refugees
Authors: Rorick Daniel Tovar Galvan
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The 1951 Convention relating to the status of refugees contains a conflict of law rule for the determination of the applicable law to marriage. The wording of this provision leaves much to be desired as it uses the domicile and the residence of the spouses as single main and subsidiary connecting factors. In cases where couples live in different countries, the law applicable to the case is unclear. The same problem arises when refugees are married to individuals outside of the convention’s scope of application. Different interpretations of this legal provision have arisen to solve this problem. Courts in a number of European countries apply the so-called modification doctrine: states should apply their domestic private international rules in all cases involving refugees. Courts shall, however, replace the national connecting factor by the domicile or residence in situations where nationality is used to determine the applicable law. The internal conflict of law rule will then be slightly modified in order to be applied according to the convention. However, this approach excludes these people from using their national law if they so desire. As nationality is, in all cases, replaced by domicile or residence as connecting factor, refugees are automatically deprived of the possibility to choose this law in jurisdictions that include the party autonomy in international marriage law. This contribution aims to shed light on the international legal framework applicable to marriages celebrated by refugees and the unnecessary restrictions to the exercise of the party autonomy these individuals are subjected to. The interest is motivated by the increasing number of displaced people, the significant number of states party to the Refugee Convention – approximately 150 – and the fact that more and more countries allow choice of law agreements in marriage law. Based on a study of German, Spanish and Swiss case law, the current practices in Europe, as well as some incoherencies derived from the current interpretation of the convention, will be discussed. The main objective is showing that there is neither an economic nor a legal basis to deny refugees the right to choose the law of their country of origin in those jurisdictions providing for this possibility to other foreigners. Quite the contrary, after analyzing other provisions contained in the conventions, this restriction would mean a contravention of other obligations included in the text.Keywords: choice of law, conflict of laws, international marriage law, refugees
Procedia PDF Downloads 1453882 Forensic Study on Personal Identification of Pakistani Population by Individualizing Characteristics of Footprints
Authors: Muneeba Butt
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One of the most important physical evidence which leaves suspects at the crime scene is footprints. Analysis of footprints, which can provide useful information for personal identification, is helpful in crime scene investigation. For the current study, 200 samples collected (144 male and 56 female) from Pakistani population with a consent form. The footprints were collected by using black ink with an ink pad. The entire samples were photographed, and then the magnifying glass was used for visualization of individual characteristics including detail of toes, humps, phalange mark, and flat foot cracks in footprint patterns. The descriptive results of individualizing characteristics features were presented in tabular form with respective frequency and percentage. In the result in the male population, the prevalence of tibialis type (T-type) is highest. In the female population, the prevalence of midularis type (M-type) is highest. Humps on the first toe are more found in the male population rather than other humps. In the female population, humps on the third toe are more found rather than other humps. In the male population, the prevalence of phalange mark by toe 1 is highest followed by toe 3, toe 5, toe 2, toe 4 and in female population the prevalence of phalange mark by toe 1 is highest followed by toe 5, 4, 3 and 2. Creases marks are found highest in male population as compared to the female population.Keywords: foot prints, toes, humps, cracks
Procedia PDF Downloads 1623881 Association Nephropathy and Hypertension in Diabetic Patients
Authors: Bahlous Afef, Bouzid Kahena, Bardkis Ahlem, Mrad Mehdi, Kalai Eya, Sonia Bahri, Abdelmoula Jaouida
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Diabetic nephropathy is the first cause of chronic renal failure and hemodialysis use in several countries including Tunisia. The role of hypertension (HT) as major risk factor for nephropathy is undeniable. The aim of our study was to determine the relationship between blood pressure and nephropathy in a population of diabetic type 2 recently discovered. Materials and methods: We conducted a prospective study focused on 60 patients with type 2 diabetes recently discovered (<5 years). Each patient have benefited from: -a full clinical examination with measurement of blood pressure - exploring a blood-glucose control and renal function -urinary exploration with the determination of proteinuria microalbuminumie of 24 hours with a immunoturbidimetric method using Architect (ABBOTT CI 8200). Results and discussion: Hypertension was present in 46.7% of cases. Twenty patients, 35% of the study population showed nephropathy. Four of these patients (6.66% of cases) had proteinuria, while 16 (26.6% of patients) had microalbuminuria (> 30mg/24 hours). Systolic blood pressure was significantly (p < 0.05) associated with the presence of nephropathy (139 +19.44) vs. for the group with normal renal function (128.65 +15.12 mmHg). Conclusion: The etiology of diabetic nephropathy is multifactorial. However, systolic blood pressure and glycemic control remains the major risk factors. Better glycemic control and treatment of hypertension allowed preventing and slowing the progression of diabetic nephropathy.Keywords: hypertension, nephropathy, hemodialysis, diabetes
Procedia PDF Downloads 3153880 A Prospective Study of a Modified Pin-In-Plaster Technique for Treatment of Distal Radius Fractures
Authors: S. alireza Mirghasemi, Shervin Rashidinia, Mohammadsaleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, S. Shahin Eftekhari, Sara Shahmoradi
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Purpose: There are various pin-in-plaster methods for treating distal radius fractures. This study is meant to introduce a modified technique of pin-in-plaster. Materials and methods: Fifty-four patients with distal radius fractures were followed up for one year. Patients were excluded if they had type B fractures according to AO classification, multiple injuries or pathological fractures, and were treated more than 7 days after injury. Range of motion and functional results were evaluated. Radiographic parameters including radial inclination, tilt, and height, were measured preoperatively and postoperatively. Results: The average radial tilt was 10.6° and radial height was 10.2 mm at the sixth month postoperatively. Three cases of pin tract infection were recorded, who were treated totally with oral antibiotics. There was no case of pin loosening. Of total 73 patients underwent surgery, three cases of radial nerve irritation were recorded at the time of cast removal. All of them resolved at the 6th month follow up. No median nerve compression and carpal tunnel syndrome have found. We also had no case of tendon injury. Conclusion: Our modified technique is effective to restore anatomic congruity and maintain reduction.Keywords: distal radius fracture, percutaneous pinning, pin-in-plaster, modified method of pin-in-plaster, operative treatment
Procedia PDF Downloads 5083879 Temperature-Related Alterations to Mineral Levels and Crystalline Structure in Porcine Long Bone: Intense Heat Vs. Open Flame
Authors: Caighley Logan
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The outcome of fire related fatalities, along with other research, has found fires can have a detrimental effect to the mineral and crystalline structures within bone. This study focused on the mineral and crystalline structures within porcine bone samples to analyse the changes caused, with the intent of effectively ‘reverse engineering’ the data collected from burned bone samples to discover what may have happened. Using Fourier Transform Infrared (FT-IR), and X-Ray Fluorescence (XRF), the data collected from a controlled source of intense heat (muffle furnace) and an open fire, based in a living room setting in a standard size shipping container (8.5ft x 8ft) of a similar temperature with a known ignition source, a gasoline lighter. This approach is to analyse the changes to the samples and how the changes differ depending on the heat source. Results have found significant differences in the levels of remaining minerals for each type of heat/burning (p=<0.001), particularly Phosphorus and Calcium, this also includes notable additions of absorbed elements and minerals from the surrounding materials, i.e., Cerium (Ce), Bromine (Br) and Neodymium (Ne). The analysis techniques included provide validated results in conjunction with previous studies.Keywords: forensic anthropology, thermal alterations, porcine bone, FTIR, XRF
Procedia PDF Downloads 833878 Analysis of Spectral Radiative Entropy Generation in a Non-Gray Participating Medium with Heat Source (Furnaces)
Authors: Asadollah Bahrami
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In the present study, spectral radiative entropy generation is analyzed in a furnace filled with a mixture of H₂O, CO₂ and soot at radiative equilibrium. For the angular and spatial discretization of the radiative transfer equation and radiative entropy generation equations, the discrete ordinates method and the finite volume method are used, respectively. Spectral radiative properties are obtained using the correlated-k (CK) non-gray model with updated parameters based on the HITEMP2010 high-resolution database. In order to evaluate the effects of the location of the heat source, boundary condition and wall emissivity on radiative entropy generation, five cases are considered with different conditions. The spectral and total radiative entropy generation in the system are calculated for all cases and the effects of mentioned parameters on radiative entropy generation are attentively analyzed and finally, the optimum condition is especially presented. The most important results can be stated as follows: Results demonstrate that the wall emissivity has a considerable effect on the radiative entropy generation. Also, irreversible radiative transfer at the wall with lower temperatures is the main source of radiative entropy generation in the furnaces. In addition, the effect of the location of the heat source on total radiative entropy generation is less than other factors. Eventually, it can be said that characterizing the effective parameters of radiative entropy generation provides an approach to minimizing the radiative entropy generation and enhancing the furnace's performance practicality.Keywords: spectral radiative entropy generation, non-gray medium, correlated k(CK) model, heat source
Procedia PDF Downloads 993877 Role of Toll Like Receptor-2 in Female Genital Tuberculosis Disease Infection and Its Severity
Authors: Swati Gautam, Salman Akhtar, S. P. Jaiswar, Amita Jain
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Background: FGTB is now a major global health problem mostly in developing countries including India. In humans, Mycobacterium Tuberculosis (M.tb) is a causating agent of infection. High index of suspicion is required for early diagnosis due to asymptomatic presentation of FGTB disease. In macrophages Toll Like Receptor-2 (TLR-2) is one which mediated host’s immune response to M.tb. The expression of TLR-2 on macrophages is important to determine the fate of innate immune responses to M.tb. TLR-2 have two work. First its high expression on macrophages worsen the outer of infection and another side, it maintains M.tb to its dormant stage avoids activation of M.tb from latent phase. Single Nucleotide Polymorphism (SNP) of TLR-2 gene plays an important role in susceptibility to TB among different populations and subsequently, in the development of infertility. Methodology: This Case-Control study was done in the Department of Obs and Gynae and Department of Microbiology at King George’s Medical University, U.P, Lucknow, India. Total 300 subjects (150 Cases and 150 Controls) were enrolled in the study. All subjects were enrolled only after fulfilling the given inclusion and exclusion criteria. Inclusion criteria: Age 20-35 years, menstrual-irregularities, positive on Acid-Fast Bacilli (AFB), TB-PCR, (LJ/MGIT) culture in Endometrial Aspiration (EA). Exclusion criteria: Koch’s active, on ATT, PCOS, and Endometriosis fibroid women, positive on Gonococal and Chlamydia. Blood samples were collected in EDTA tubes from cases and healthy control women (HCW) and genomic DNA extraction was carried out by salting-out method. Genotyping of TLR2 genetic variants (Arg753Gln and Arg677Trp) were performed by using single amplification refractory mutation system (ARMS) PCR technique. PCR products were analyzed by electrophoresis on 1.2% agarose gel and visualized by gel-doc. Statistical analysis of the data was performed using the SPSS 16.3 software and computing odds ratio (OR) with 95% CI. Linkage Disequiliribium (LD) analysis was done by SNP stats online software. Results: In TLR-2 (Arg753Gln) polymorphism significant risk of FGTB observed with GG homozygous mutant genotype (OR=13, CI=0.71-237.7, p=0.05), AG heterozygous mutant genotype (OR=13.7, CI=0.76-248.06, p=0.03) however, G allele (OR=1.09, CI=0.78-1.52, p=0.67) individually was not associated with FGTB. In TLR-2 (Arg677Trp) polymorphism a significant risk of FGTB observed with TT homozygous mutant genotype (OR= 0.020, CI=0.001-0.341, p < 0.001), CT heterozygous mutant genotype (OR=0.53, CI=0.33-0.86, p=0.014) and T allele (OR=0.463, CI=0.32-0.66, p < 0.001). TT mutant genotype was only found in FGTB cases and frequency of CT heterozygous more in control group as compared to FGTB group. So, CT genotype worked as protective mutation for FGTB susceptibility group. In haplotype analysis of TLR-2 genetic variants, four possible combinations, i.e. (G-T, A-C, G-C, and A-T) were obtained. The frequency of haplotype A-C was significantly higher in FGTB cases (0.32). Control group did not show A-C haplotype and only found in FGTB cases. Conclusion: In conclusion, study showed a significant association with both genetic variants of TLR-2 of FGTB disease. Moreover, the presence of specific associated genotype/alleles suggest the possibility of disease severity and clinical approach aimed to prevent extensive damage by disease and also helpful for early detection of disease.Keywords: ARMS, EDTA, FGTB, TLR
Procedia PDF Downloads 3043876 Economies of Scale of Worker's Continuing Professional Development in Selected Universities in South- South, Nigeria
Authors: Jonathan E. Oghenekohwo
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The return to scale constitutes a significant investment index in the determination of the quantum of resources that is deployed in investment decision on worker’s continuing professional development. Such investment decision is always predicted on the expected outcomes to the individual, institution and the society in context. Several investments in the development of human capacity on the job have been made, but the return to the scale of such seems not to have been correlated positively with the quantum of resources invested in terms of productivity and performance among workers in many universities. This paper thus found out that, despite the commitment and policy instrument to avail workers the right of continuing professional development, the multiplier effects are not evident in diligence, commitment, honesty, dedication, productivity and improved performance on the job among most administrative staff in Nigerian Universities This author, therefore concludes that, given the policy on the right of workers to get trained on-the job, the outcomes of such training must reflect on the overall performance indices, otherwise, institutions should carry out a forensic analysis of the types of continuing professional development programmes that workers participate in, whether or not, they are consistent with the vision and mission of the institutions in terms of economies of scale of workers professional development to the individual, institution and the nation in context.Keywords: continuing, professional development, economies of scale, worker’s education, administrative staff
Procedia PDF Downloads 3243875 For Whom Is Legal Aid: A Critical Analysis of the State-Funded Legal Aid in Criminal Cases in Tajikistan
Authors: Umeda Junaydova
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Legal aid is a key element of access to justice. According to UN Principles and Guidelines on Access to Legal Aid in Criminal Justice Systems, state members bear the obligation to put in place accessible, effective, sustainable, and credible legal aid systems. Regarding this obligation, developing countries, such as Tajikistan, faced challenges in terms of financing this system. Thus, many developed nations have launched rule-of-law programs to support these states and ensure access to justice for all. Following independence from the Soviet Union, Tajikistan committed to introducing the rule of law and providing access to justice. This newly established country was weak, and the sudden outbreak of civil war aggravated the situation even more. The country needed external support and opened its door to attract foreign donors to assist it in its way to development. In 2015, Tajikistan, with the financial support of development partners, was able to establish a state-funded legal aid system that provides legal assistance to vulnerable and marginalized populations, including in criminal cases. In the beginning, almost the whole system was financed from donor funds; by that time, the contribution of the government gradually increased, and currently, it covers 80% of the total budget. All these governments' actions toward ensuring access to criminal legal aid for disadvantaged groups look promising; however, the reality is completely different. Currently, not all disadvantaged people are covered by these services, and their cases are most of the time considered without appropriate defense, which leads to violation of fundamental human rights. This research presents a comprehensive exploration of the interplay between donor assistance and the effectiveness of legal aid services in Tajikistan, with a specific focus on criminal cases involving vulnerable groups, such as women and children. In the context of Tajikistan, this study addresses a pressing concern: despite substantial financial support from international donors, state-funded legal aid services often fall short of meeting the needs of poor and vulnerable populations. The study delves into the underlying complexities of this issue and examines the structural, operational, and systemic challenges faced by legal aid providers, shedding light on the factors contributing to the ineffectiveness of legal aid services. Furthermore, it seeks to identify the root causes of these issues, revealing the barriers that hinder the delivery of adequate legal aid services. The research adopts a socio-legal methodology to ensure an appropriate combination of multiple methodologies. The findings of this research hold significant implications for both policymakers and practitioners, offering insights into the enhancement of legal aid services and access to justice for disadvantaged and marginalized populations in Tajikistan. By addressing these pressing questions, this study aims to fill the gap in legal literature and contribute to the development of a more equitable and efficient legal aid system that better serves the needs of the most vulnerable members of society.Keywords: access to justice, legal aid, rule of law, rights for council
Procedia PDF Downloads 493874 Comprehensive Evaluation of COVID-19 Through Chest Images
Authors: Parisa Mansour
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The coronavirus disease 2019 (COVID-19) was discovered and rapidly spread to various countries around the world since the end of 2019. Computed tomography (CT) images have been used as an important alternative to the time-consuming RT. PCR test. However, manual segmentation of CT images alone is a major challenge as the number of suspected cases increases. Thus, accurate and automatic segmentation of COVID-19 infections is urgently needed. Because the imaging features of the COVID-19 infection are different and similar to the background, existing medical image segmentation methods cannot achieve satisfactory performance. In this work, we try to build a deep convolutional neural network adapted for the segmentation of chest CT images with COVID-19 infections. First, we maintain a large and novel chest CT image database containing 165,667 annotated chest CT images from 861 patients with confirmed COVID-19. Inspired by the observation that the boundary of an infected lung can be improved by global intensity adjustment, we introduce a feature variable block into the proposed deep CNN, which adjusts the global features of features to segment the COVID-19 infection. The proposed PV array can effectively and adaptively improve the performance of functions in different cases. We combine features of different scales by proposing a progressive atrocious space pyramid fusion scheme to deal with advanced infection regions with various aspects and shapes. We conducted experiments on data collected in China and Germany and showed that the proposed deep CNN can effectively produce impressive performance.Keywords: chest, COVID-19, chest Image, coronavirus, CT image, chest CT
Procedia PDF Downloads 553873 A Study on Coronary Artery Dominance and Divisions of Main Trunk of Left Coronary Artery in Adult Human Cadaveric Hearts of South Indian Population
Authors: Chethan Purushothama
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Coronary artery disease is one of the major causes of death in developing countries. The coronary arteries show wide range of variations and these variations have not been dealt with different population groups. The present study aims to focus on the pattern and variations of coronary artery in south Indian population. The study was performed to analyze the coronary artery dominance and divisions of main trunk of left coronary artery in 81 isolated adult human cadaveric hearts of South Indian population. The specimens were fixed in 10% formalin and were dissected manually. In our specimens, 74.1% of the hearts were right dominant, 11.1% were left dominant, and 14.8% were co-dominant. Bifurcation, trifurcation, and quadrifurcation of main trunk of left coronary artery were seen in 49.4%, 48.1%, and 2.5% cases respectively. The right dominant hearts had bifurcation, trifurcation and quadrifurcation of main trunk of left coronary artery in 46.7%, 50% and 3.3% hearts respectively. The left dominant hearts had bifurcation and trifurcation of main trunk of left coronary artery in 55.6% and 44.4% cases respectively. The co-dominant hearts had bifurcation and trifurcation of main trunk of left coronary artery in 58.3% and 41.7% respectively. Quadrifurcation of main trunk of left coronary artery were seen only in right dominant hearts. We believe that the data obtained from the present study are important to the interventional cardiologists and radiologists. The details obtained will also be helpful for the clinical anatomists.Keywords: bifurcation, coronary artery, trifurcation, quadrifurcation
Procedia PDF Downloads 3873872 Application of Genetic Algorithm with Multiobjective Function to Improve the Efficiency of Photovoltaic Thermal System
Authors: Sonveer Singh, Sanjay Agrawal, D. V. Avasthi, Jayant Shekhar
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The aim of this paper is to improve the efficiency of photovoltaic thermal (PVT) system with the help of Genetic Algorithms with multi-objective function. There are some parameters that affect the efficiency of PVT system like depth and length of the channel, velocity of flowing fluid through the channel, thickness of the tedlar and glass, temperature of inlet fluid i.e. all above parameters are considered for optimization. An attempt has been made to the model and optimizes the parameters of glazed hybrid single channel PVT module when two objective functions have been considered separately. The two objective function for optimization of PVT module is overall electrical and thermal efficiency. All equations for PVT module have been derived. Using genetic algorithms (GAs), above two objective functions of the system has been optimized separately and analysis has been carried out for two cases. Two cases are: Case-I; Improvement in electrical and thermal efficiency when overall electrical efficiency is optimized, Case-II; Improvement in electrical and thermal efficiency when overall thermal efficiency is optimized. All the parameters that are used in genetic algorithms are the parameters that could be changed, and the non-changeable parameters, like solar radiation, ambient temperature cannot be used in the algorithm. It has been observed that electrical efficiency (14.08%) and thermal efficiency (19.48%) are obtained when overall thermal efficiency was an objective function for optimization. It is observed that GA is a very efficient technique to estimate the design parameters of hybrid single channel PVT module.Keywords: genetic algorithm, energy, exergy, PVT module, optimization
Procedia PDF Downloads 6043871 Prognostic Value of C-Reactive Protein (CRP) in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Sub-Saharan Africa
Authors: Teklay Gebrecherkos, Mahmud Abdulkader, Tobias Rinke De Wit, Britta C. Urban, Feyissa Chala, Yazezew Kebede, Dawit Welday
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Background: C-reactive protein (CRP) levels are a reliable surrogate for interleukin-6 bioactivity that plays a pivotal role in the pathogenesis of cytokine storm associated with severe COVID-19. There is a lack of data on the role of CRP as a determinant of COVID-19 severity status in the African context. Methods: We determined the longitudinal kinetics of CRP levels on 78 RT-PCR-confirmed COVID-19 patients (49 non-severe and 29 severe cases) and 50 PCR-negative controls. Results: COVID-19 patients had overall significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0-127.8) mg/L vs. 0.9 (IQR: 0.5-1.9) mg/L; p=0.0004)]. Moreover, severe COVID-19 patients had significantly higher median CRP levels than non-severe cases [166.1 (IQR: 48.6-332.5) mg/L vs. 2.4 (IQR: 1.2-7.6) mg/L; p<0.00001)]. In addition, persistently elevated levels of CRP were exhibited among those with comorbidities and higher age groups. Area under receiver operating characteristic curve (AUC) analysis of CRP levels distinguished PCR-confirmed COVID-19 patients from the ones with PCR-negative non-COVID-19 individuals, with an AUC value of 0.77 (95% CI: 0.68-0.84; p=0.001). Moreover, it clearly distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73-0.91). After adjusting for age and the presence of comorbidities, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 (adjusted relative risk 3.99 (95%CI: 1.35-11.82; p=0.013). Conclusions: Determining CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes.Keywords: CRP, COVID-19, SARS-CoV-2, biomarker
Procedia PDF Downloads 803870 Pathomorphological Markers of the Explosive Wave Action on Human Brain
Authors: Sergey Kozlov, Juliya Kozlova
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Introduction: The increased attention of researchers to an explosive trauma around the world is associated with a constant renewal of military weapons and a significant increase in terrorist activities using explosive devices. Explosive wave is a well known damaging factor of explosion. The most sensitive to the action of explosive wave in the human body are the head brain, lungs, intestines, urine bladder. The severity of damage to these organs depends on the distance from the explosion epicenter to the object, the power of the explosion, presence of barriers, parameters of the body position, and the presence of protective clothing. One of the places where a shock wave acts, in human tissues and organs, is the vascular endothelial barrier, which suffers the greatest damage in the head brain and lungs. The objective of the study was to determine the pathomorphological changes of the head brain followed the action of explosive wave. Materials and methods of research: To achieve the purpose of the study, there have been studied 6 male corpses delivered to the morgue of Municipal Institution "Dnipropetrovsk regional forensic bureau" during 2014-2016 years. The cause of death of those killed was a military explosive injury. After a visual external assessment of the head brain, for histological study there was conducted the 1 x 1 x 1 cm/piece sampling from different parts of the head brain, i.e. the frontal, parietal, temporal, occipital sites, and also from the cerebellum, pons, medulla oblongata, thalamus, walls of the lateral ventricles, the bottom of the 4th ventricle. Pieces of the head brain were immersed in 10% formalin solution for 24 hours. After fixing, the paraffin blocks were made from the material using the standard method. Then, using a microtome, there were made sections of 4-6 micron thickness from paraffin blocks which then were stained with hematoxylin and eosin. Microscopic analysis was performed using a light microscope with x4, x10, x40 lenses. Results of the study: According to the results of our study, injuries of the head brain were divided into macroscopic and microscopic. Macroscopic injuries were marked according to the results of visual assessment of haemorrhages under the membranes and into the substance, their nature, and localisation, areas of softening. In the microscopic study, our attention was drawn to both vascular changes and those of neurons and glial cells. Microscopic qualitative analysis of histological sections of different parts of the head brain revealed a number of structural changes both at the cellular and tissue levels. Typical changes in most of the studied areas of the head brain included damages of the vascular system. The most characteristic microscopic sign was the separation of vascular walls from neuroglia with the formation of perivascular space. Along with this sign, wall fragmentation of these vessels, haemolysis of erythrocytes, formation of haemorrhages in the newly formed perivascular spaces were found. In addition to damages of the cerebrovascular system, destruction of the neurons, presence of oedema of the brain tissue were observed in the histological sections of the brain. On some sections, the head brain had a heterogeneous step-like or wave-like nature. Conclusions: The pathomorphological microscopic changes in the brain, identified in the study on the died of explosive traumas, can be used for diagnostic purposes in conjunction with other characteristic signs of explosive trauma in forensic and pathological studies. The complex of microscopic signs in the head brain, i.e. separation of blood vessel walls from neuroglia with the perivascular space formation, fragmentation of walls of these blood vessels, erythrocyte haemolysis, formation of haemorrhages in the newly formed perivascular spaces is the direct indication of explosive wave action.Keywords: blast wave, neurotrauma, human, brain
Procedia PDF Downloads 1903869 A Study on Reliability of Gender and Stature Determination by Odontometric and Craniofacial Anthropometric Parameters
Authors: Churamani Pokhrel, C. B. Jha, S. R. Niraula, P. R. Pokharel
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Human identification is one of the most challenging subjects that man has confronted. The determination of adult sex and stature are two of the four key factors (sex, stature, age, and race) in identification of an individual. Craniofacial and odontometric parameters are important tools for forensic anthropologists when it is not possible to apply advanced techniques for identification purposes. The present study provides anthropometric correlation of the parameters with stature and gender and also devises regression formulae for reconstruction of stature. A total of 312 Nepalese students with equal distribution of sex i.e., 156 male and 156 female students of age 18-35 years were taken for the study. Total of 10 parameters were measured (age, sex, stature, head circumference, head length, head breadth, facial height, bi-zygomatic width, mesio-distal canine width and inter-canine distance of both maxilla and mandible). Co-relation and regression analysis was done to find the association between the parameters. All parameters were found to be greater in males than females and each was found to be statistically significant. Out of total 312 samples, the best regressor for the determination of stature was head circumference and mandibular inter-canine width and that for gender was head circumference and right mandibular teeth. The accuracy of prediction was 83%. Regression equations and analysis generated from craniofacial and odontometric parameters can be a supplementary approach for the estimation of stature and gender when extremities are not available.Keywords: craniofacial, gender, odontometric, stature
Procedia PDF Downloads 1903868 A Design for Supply Chain Model by Integrated Evaluation of Design Value and Supply Chain Cost
Authors: Yuan-Jye Tseng, Jia-Shu Li
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To design a product with the given product requirement and design objective, there can be alternative ways to propose the detailed design specifications of the product. In the design modeling stage, alternative design cases with detailed specifications can be modeled to fulfill the product requirement and design objective. Therefore, in the design evaluation stage, it is required to perform an evaluation of the alternative design cases for deciding the final design. The purpose of this research is to develop a product evaluation model for evaluating the alternative design cases by integrated evaluating the criteria of functional design, Kansei design, and design for supply chain. The criteria in the functional design group include primary function, expansion function, improved function, and new function. The criteria in the Kansei group include geometric shape, dimension, surface finish, and layout. The criteria in the design for supply chain group include material, manufacturing process, assembly, and supply chain operation. From the point of view of value and cost, the criteria in the functional design group and Kansei design group represent the design value of the product. The criteria in the design for supply chain group represent the supply chain and manufacturing cost of the product. It is required to evaluate the design value and the supply chain cost to determine the final design. For the purpose of evaluating the criteria in the three criteria groups, a fuzzy analytic network process (FANP) method is presented to evaluate a weighted index by calculating the total relational values among the three groups. A method using the technique for order preference by similarity to ideal solution (TOPSIS) is used to compare and rank the design alternative cases according to the weighted index using the total relational values of the criteria. The final decision of a design case can be determined by using the ordered ranking. For example, the design case with the top ranking can be selected as the final design case. Based on the criteria in the evaluation, the design objective can be achieved with a combined and weighted effect of the design value and manufacturing cost. An example product is demonstrated and illustrated in the presentation. It shows that the design evaluation model is useful for integrated evaluation of functional design, Kansei design, and design for supply chain to determine the best design case and achieve the design objective.
Keywords: design for supply chain, design evaluation, functional design, Kansei design, fuzzy analytic network process, technique for order preference by similarity to ideal solution
Procedia PDF Downloads 3173867 Analysis of Nonlinear Dynamic Systems Excited by Combined Colored and White Noise Excitations
Authors: Siu-Siu Guo, Qingxuan Shi
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In this paper, single-degree-of-freedom (SDOF) systems to white noise and colored noise excitations are investigated. By expressing colored noise excitation as a second-order filtered white noise process and introducing colored noise as an additional state variable, the equation of motion for SDOF system under colored noise is then transferred artificially to multi-degree-of-freedom (MDOF) system under white noise excitations. As a consequence, corresponding Fokker-Planck-Kolmogorov (FPK) equation governing the joint probabilistic density function (PDF) of state variables increases to 4-dimension (4-D). Solution procedure and computer programme become much more sophisticated. The exponential-polynomial closure (EPC) method, widely applied for cases of SDOF systems under white noise excitations, is developed and improved for cases of systems under colored noise excitations and for solving the complex 4-D FPK equation. On the other hand, Monte Carlo simulation (MCS) method is performed to test the approximate EPC solutions. Two examples associated with Gaussian and non-Gaussian colored noise excitations are considered. Corresponding band-limited power spectral densities (PSDs) for colored noise excitations are separately given. Numerical studies show that the developed EPC method provides relatively accurate estimates of the stationary probabilistic solutions. Moreover, statistical parameter of mean-up crossing rate (MCR) is taken into account, which is important for reliability and failure analysis.Keywords: filtered noise, narrow-banded noise, nonlinear dynamic, random vibration
Procedia PDF Downloads 2243866 Bone Mineral Density in Egyptian Children with Familial Mediterranean Fever
Authors: S. Salah, S. A. El-Masry, H. F. Sheba, R. A. El-Banna, W. Saad
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Background: Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). Objective: To assess BMD in Egyptian children with FMF on genetic basis. Subjects and Methods: A cross sectional study included 45 FMF patients and 25 control children of both sexes, with age range between 3-16 years old. The patients were reclassified into 2 groups: Group I (A) 23 cases used colchicines for 1 month or less, and Group I (B) 22 cases used colchicines for more than 6 months. For both patients and control, MEFV mutations were defined using molecular genetics technique and BMD was measured by DXA at 2 sites: proximal femur and the lumber spines. Results: four frequent gene mutations were found in the patient group: E148Q (35.6%), V726A (33.3%), M680I (28.9.0%) and M694V (2.2%). There were also 4 heterozygous gene mutations in 40% of control children. Patients received colchicines treatment for less than 1 month had highly significant lower values of BMD at femur and lumber spines than control children (p<0.05). Patients received colchicines treatment for more than 6 months had improved values of BMD at femur compared to control, but there were still significant differences between them at lumbar spine (p>0.05). There are insignificant effect of type of gene mutation on BMD and the risk of osteopenia among the patients. Conclusion: FMF had significant effect on BMD. However, regular use of colchicines treatment improves this effect mainly at femur.Keywords: familial mediterranean fever, bone mineral density, genes, children
Procedia PDF Downloads 4103865 Rabies Surveillance Data Analysis in Addis Ababa, Ethiopia during 2012/13: Retrospective Cross Sectional Study
Authors: Fantu Lombamo Untiso, Sylvia Murphy, Emily Pieracci
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Background: Rabies is a highly fatal viral disease of all warm-blooded animals including human globally. However, effective rabies control program still remains to be a reality and needs to be strengthened. Objective: Reviewing of recorded data and analyzing it to generate information on the status of rabies in Addis Ababa in the year 2012/13. Methods: A retrospective data were used from the Ethiopian Public Health Institute rabies case record book registered in the year 2012/13. Results: Among 1357 suspected rabid animals clinically examined; only 8.84% were positive for rabies. Out of 216 animal brains investigated in the laboratory with Fluorescent Antibody Technique, 55.5% were confirmed rabies positive. Among the laboratory confirmed positive rabies cases, high percentage of the animals came from Yeka (20%) and lower number from Kirkos subcity (3.3%). Out of 1149 humans who came to the institute seeking anti-rabies post-exposure prophylaxis, 85.65% and 7.87% of them were exposed to suspected dogs and cats respectively. 3 human deaths due to rabies were reported in the year after exposure to dog bite of unknown vaccination status. Conclusion: The principal vector of rabies in Addis Ababa is dog. Effective rabies management and control based on confirmed cases and mass-immunization and control of stray dog populations is recommended.Keywords: Addis Ababa, exposure, rabies, surveillance
Procedia PDF Downloads 1783864 Gallbladder Amyloidosis Causing Gangrenous Cholecystitis: A Case Report
Authors: Christopher Leung, Guillermo Becerril-Martinez
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Amyloidosis is a rare systemic disease where abnormal proteins invade various organs and impede their function. Occasionally, they can manifest in a solidary organ such as the heart, lung, and nervous systems; rarely do they manifest in the gallbladder. Diagnosis often requires biopsy of the affected area and histopathology shows deposition of abnormally folded globular proteins called amyloid proteins. This case presents a 69-year-old male with a 3-month history of RUQ pain, diarrhea and non-specific symptoms of tiredness, etc. On imaging, both his US and CT abdomen showed gallbladder wall thickening and pericholecystic fluid, which may represent acute cholecystitis with hypodense lesions around the gallbladder, possibly representing liver abscesses. Given his symptoms of abdominal pain and imaging findings, this gentleman eventually had a laparoscopic cholecystectomy showing a gangrenous gallbladder with a mass on the liver bed. On histopathology, it showed amorphous hyaline eosinophilic material, which Congo-stained confirmed amyloidosis. Amyloidosis explained his non-specific symptoms, he avoided further biopsy, and he was commenced immediately on Lenalidomide. Involvement of the gallbladder is extremely rare, with less than 30 cases around the world. Half of the cases are reported as primary amyloidosis. This case adds to the current literature regarding primary gallbladder amyloidosis. Importantly, this case highlights how laparoscopic cholecystectomy can help with the diagnosis of gallbladder amyloidosis.Keywords: amyloidosis, cholecystitis, gangrenous cholecystitis, gallbladder, systemic amyloidosis
Procedia PDF Downloads 2073863 Recognising Patients’ Perspective on Health Behaviour Problems Through Laughter: Implications for Patient-Centered Care Practice in Behaviour Change Consultations in General Practice
Authors: Binh Thanh Ta, Elizabeth Sturgiss
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Central to patient-centered care is the idea of treating a patient as a person and understanding their perspectives regarding their health conditions and care preferences. Surprisingly, little is known about how GPs can understand their patients’ perspectives. This paper addresses the challenge of understanding patient perspectives in behavior change consultations by adopting Conversation Analysis (CA), which is an empirical research approach that allows both researchers and the audience to examine patients’ perspectives as displayed in GP-patient interaction. To understand people’s perspectives, CA researchers do not rely on what they say but instead on how they demonstrate their endogenous orientations to social norms when they interact with each other. Underlying CA is the notion that social interaction is orderly by all means. (It is important to note that social orders should not be treated as exogenous sets of rules that predetermine human behaviors. Rather social orders are constructed and oriented by social members through their interactional practices. Also, note that these interactional practices are the resources shared by all social members). As CA offers tools to uncover the orderliness of interactional practices, it not only allows us to understand the perspective of a particular patient in a particular medical encounter but, more importantly, enables us to recognise the shared interactional practice for signifying a particular perspective. Drawing on the 10 video-recorded consultations on behavior change in primary care, we have discovered the orderliness of patient laughter when reporting health behaviors, which signifies their orientation to the problematic nature of the reported behaviors. Among 24 cases where patients reported their health behaviors, we found 19 cases in which they laughed while speaking. In the five cases where patients did not laugh, we found that they explicitly framed their behavior as unproblematic. This finding echoes the CA body research on laughter, which suggests that laughter produced by first speakers (as opposed to laughing in response to what has been said earlier) normally indicates some sort of problems oriented to the self (e.g. self-tease, self-depreciation, etc.). This finding points to the significance of understanding when and why patients laugh; such understanding would assist GPs to recognise whether patients treat their behavior as problematic or not, thereby producing responses sensitive to patient perspectives.Keywords: patient centered care, laughter, conversation analysis, primary care, behaviour change consultations
Procedia PDF Downloads 983862 An Assessment of Inferior Dental (IDN) and Lingual Nerve (LN) Injuries Following Third Molar Removal Under LA, IVS, and GA - An Audit and Case-Series
Authors: Aamna Tufail, Catherine Anyanwu
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Introduction/Aims: Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard. A secondary objective was to provide a descriptive summary of identified cases for clinical learning. Materials and Methods: A retrospective audit was conducted by a telephone survey of 101 patients who had third molar extractions performed under LA, IVS, or GA from January 2019 to June 2020 at a District General Hospital. The results were compared to a clinical standard identified as Cheng et al1. Data collection included mode of surgery, mode of anaesthesia, grade of clinician, assessment of difficulty, severity, and duration of symptoms. Results/Statistics: A total of 101 patients had 136 third molars extracted. Age range was 18-84 years. 44% extractions were under LA, 52% under GA, and 4% under IV sedation. 30% were simple extractions, 68% were surgical removals, 2% were unspecified. 89% extractions were performed by an Associate Specialist, 5% by a consultant, and 6% by unspecified grade of clinician. The rate of IDN injuries was 2.9% (n=4), higher than standard (0.3%). The rate of LN injuries was 0.7% (n=1), same as standard (0.7%). The 5 cases of neurosensory deficits are discussed in detail. Conclusions/Clinical Relevance: The rate of ID nerve injuries was higher than the standard. The rate of LN complications was lower than the standard.Keywords: inferior dental nerve, lingual nerve, nerve injuries, third molars
Procedia PDF Downloads 913861 Starting the Hospitalization Procedure with a Medicine Combination in the Cardiovascular Department of the Imam Reza (AS) Mashhad Hospital
Authors: Maryamsadat Habibi
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Objective: pharmaceutical errors are avoidable occurrences that can result in inappropriate pharmaceutical use, patient harm, treatment failure, increased hospital costs and length of stay, and other outcomes that affect both the individual receiving treatment and the healthcare provider. This study aimed to perform a reconciliation of medications in the cardiovascular ward of Imam Reza Hospital in Mashhad, Iran, and evaluate the prevalence of medication discrepancies between the best medication list created for the patient by the pharmacist and the medication order of the treating physician there. Materials & Methods: The 97 patients in the cardiovascular ward of the Imam Reza Hospital in Mashhad were the subject of a cross-sectional study from June to September of 2021. After giving their informed consent and being admitted to the ward, all patients with at least one underlying condition and at least two medications being taken at home were included in the study. A medical reconciliation form was used to record patient demographics and medical histories during the first 24 hours of admission, and the information was contrasted with the doctors' orders. The doctor then discovered medication inconsistencies between the two lists and double-checked them to separate the intentional from the accidental anomalies. Finally, using SPSS software version 22, it was determined how common medical discrepancies are and how different sorts of discrepancies relate to various variables. Results: The average age of the participants in this study was 57.6915.84 years, with 57.7% of men and 42.3% of women. 95.9% of the patients among these people encountered at least one medication discrepancy, and 58.9% of them suffered at least one unintentional drug cessation. Out of the 659 medications registered in the study, 399 cases (60.54%) had inconsistencies, of which 161 cases (40.35%) involved the intentional stopping of a medication, 123 cases (30.82%) involved the stopping of a medication unintentionally, and 115 cases (28.82%) involved the continued use of a medication by adjusting the dose. Additionally, the category of cardiovascular pharmaceuticals and the category of gastrointestinal medications were found to have the highest medical inconsistencies in the current study. Furthermore, there was no correlation between the frequency of medical discrepancies and the following variables: age, ward, date of visit, type, and number of underlying diseases (P=0.13), P=0.61, P=0.72, P=0.82, P=0.44, and so forth. On the other hand, there was a statistically significant correlation between the number of medications taken at home (P=0.037) and the prevalence of medical discrepancies with gender (P=0.029). The results of this study revealed that 96% of patients admitted to the cardiovascular unit at Imam Reza Hospital had at least one medication error, which was typically an intentional drug discontinuance. According to the study's findings, patients admitted to Imam Reza Hospital's cardiovascular ward have a great potential for identifying and correcting various medication discrepancies as well as for avoiding prescription errors when the medication reconciliation method is used. As a result, it is essential to carry out a precise assessment to achieve the best treatment outcomes and avoid unintended medication discontinuation, unwanted drug-related events, and drug interactions between the patient's home medications and those prescribed in the hospital.Keywords: drug combination, drug side effects, drug incompatibility, cardiovascular department
Procedia PDF Downloads 873860 Passive Retrofitting Strategies for Windows in Hot and Humid Climate Vijayawada
Authors: Monica Anumula
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Nowadays human beings attain comfort zone artificially for heating, cooling and lighting the spaces they live, and their main importance is given to aesthetics of building and they are not designed to protect themselves from climate. They depend on artificial sources of energy resulting in energy wastage. In order to reduce the amount of energy being spent in the construction industry and Energy Package goals by 2020, new ways of constructing houses is required. The larger part of energy consumption of a building is directly related to architectural aspects hence nature has to be integrated into the building design to attain comfort zone and reduce the dependency on artificial source of energy. The research is to develop bioclimatic design strategies and techniques for the walls and roofs of Vijayawada houses. Study and analysis of design strategies and techniques of various cases like Kerala, Mangalore etc. for similar kind of climate is examined in this paper. Understanding the vernacular architecture and modern techniques of that various cases and implementing in the housing of Vijayawada not only decreases energy consumption but also enhances socio cultural values of Vijayawada. This study focuses on the comparison of vernacular techniques and modern building bio climatic strategies to attain thermal comfort and energy reduction in hot and humid climate. This research provides further thinking of new strategies which include both vernacular and modern bioclimatic techniques.Keywords: bioclimatic design, energy consumption, hot and humid climates, thermal comfort
Procedia PDF Downloads 1773859 HIV and AIDS in Kosovo, Stigma Persist!
Authors: Luljeta Gashi, Naser Ramadani, Zana Deva, Dafina Gexha-Bunjaku
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The official HIV/AIDS data in Kosovo are based on HIV case reporting from health-care services, the blood transfusion system and Voluntary Counselling and Testing centres. Between 1986 and 2014, are reported 95 HIV and AIDS cases, of which 49 were AIDS, 46 HIV and 40 deaths. The majority (69%) of cases were men, age group 25 to 34 (37%) and route of transmission is: heterosexual (90%), MSM (7%), vertical transmission (2%) and IDU (1%). Based on existing data and the UNAIDS classification system, Kosovo is currently still categorised as having a low-level HIV epidemic. Even though with a low HIV prevalence, Kosovo faces a number of threatening factors, including increased number of drug users, a stigmatized and discriminated MSM community, high percentage of youth among general population (57% of the population under the age of 25), with changing social norms and especially the sexual ones. Methods: Data collection was done using self administered structured questionnaires amongst 249 high school students. Data were analysed using the Statistical Package for Social Sciences (SPSS). Results: The findings revealed that 68% of students know that HIV transmission can be reduced by having sex with only one uninfected partner who has no other partners, 94% know that the risk of getting HIV can be reduced by using a condom every time they have sex, 68% know that a person cannot get HIV from mosquito bites, 81% know that they cannot get HIV by sharing food with someone who is infected and 46% know that a healthy looking person can have HIV. Conclusions: Seventy one percent of high school students correctly identify ways of preventing the sexual transmission of HIV and who reject the major misconceptions about HIV transmission. The findings of the study indicate a need for more health education and promotion.Keywords: Kosovo, KPAR, HIV, high school
Procedia PDF Downloads 4763858 Honey Intoxication: A Unique Cause of Sudden Cardiac Collapse
Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar
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Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.Keywords: rhobdodendron, honey, grayanotoxin, bradycardia
Procedia PDF Downloads 3463857 An Approximate Lateral-Torsional Buckling Mode Function for Cantilever I-Beams
Authors: H. Ozbasaran
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Lateral torsional buckling is a global stability loss which should be considered in the design of slender structural members under flexure about their strong axis. It is possible to compute the load which causes lateral torsional buckling of a beam by finite element analysis, however, closed form equations are needed in engineering practice. Such equations can be obtained by using energy method. Unfortunately, this method has a vital drawback. In lateral torsional buckling applications of energy method, a proper function for the critical lateral torsional buckling mode should be chosen which can be thought as the variation of twisting angle along the buckled beam. The accuracy of the results depends on how close is the chosen function to the exact mode. Since critical lateral torsional buckling mode of the cantilever I-beams varies due to material properties, section properties, and loading case, the hardest step is to determine a proper mode function. This paper presents an approximate function for critical lateral torsional buckling mode of doubly symmetric cantilever I-beams. Coefficient matrices are calculated for the concentrated load at the free end, uniformly distributed load and constant moment along the beam cases. Critical lateral torsional buckling modes obtained by presented function and exact solutions are compared. It is found that the modes obtained by presented function coincide with differential equation solutions for considered loading cases.Keywords: buckling mode, cantilever, lateral-torsional buckling, I-beam
Procedia PDF Downloads 3663856 Budd-Chiari Syndrome: Common Presentation, Rare Disease
Authors: Aadil Khan, Yasser Chomayil, P. P. Venugopalan
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Background: Budd-Chiari syndrome is caused by thrombosis of the hepatic veins and/or the thrombosis of the intrahepatic or suprahepatic IVC. The etiology remains idiopathic in 16% -35% of cases. Malignancy, rheumatological disorder, myeloproliferative disease, inheritable coagulopathy, infection or hyperestrogen state can be identified in many cases. Methodology: Review of case records of the patient presented to Aster Medcity, Emergency Department, Cochin. Introduction:17 years old female was presented to ED with fever, jaundice and abdominal distention since 1 week. O/E: Pallor+, icterus+. Abdomen- gross distension+, shifting dullness+, generalized anasarca+. USG abdomen showed hepatomegaly with mild coarse echotexture and moderate to gross ascites. CT abdomen and chest showed hepatomegaly with thrombosis of all three hepatic vein and moderate ascites suggestive of Budd-Chiari syndrome. Patient was taken for catheter vein thrombolysis. Venogram done the next day revealed almost > 50% opening of the right hepatic vein. Concurrent doppler showed colour and doppler signals in middle hepatic veins. She gradually improved and was discharged home on anticoagulant and adviced regular follow up. Conclusion: Being a rare disease in this young population, high suspicion is required when evaluating young patients with abdominal pain and jaundice.Keywords: Budd-Chiari syndrome, rare disease, abdominal pain, India
Procedia PDF Downloads 2763855 Human Rabies Survivors in India: Epidemiological, Immunological and Virological Studies
Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.
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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis
Procedia PDF Downloads 3283854 Avidity and IgE versus IgG and IgM in Diagnosis of Maternal Toxoplasmosis
Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik
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Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.Keywords: diagnosis, serology, seroprevalence, toxoplasmosis
Procedia PDF Downloads 151