Search results for: managed intake
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1492

Search results for: managed intake

622 Oral Betahistine Versus Intravenous Diazepam in Acute Peripheral Vertigo: A Randomized, Double-Blind Controlled Trial

Authors: Saeed Abbasi, Davood Farsi, Soudabeh Shafiee Ardestani, Neda Valizadeh

Abstract:

Objectives: Peripheral vertigo is a common complaint of patients who are visited in emergency departments. In our study, we wanted to evaluate the effect of betahistine as an oral drug vs. intravenous diazepam for the treatment of acute peripheral vertigo. We also wanted to see the possibility of substitution of parenteral drug with an oral one with fewer side effects. Materials and Methods: In this randomized, double-blind study, 101 patients were enrolled in the study. The patients were divided in two groups in a double-blind randomized manner. Group A took oral placebo and 10 mg of intravenous diazepam. Group B received 8mg of oral betahistine and intravenous placebo. Patients’ symptoms and signs (Vertigo severity, Nausea, Vomiting, Nistagmus and Gate) were evaluated after 0, 2, 4, 6 hours by emergency physicians and data were collected by a questionnaire. Results: In both groups, there was significant improvement in vertigo (betahistine group P=0.02 and Diazepam group P=0.03). Analysis showed more improvement in vertigo severity after 4 hours of treatment in betahistine group comparing to diazepam group (P=0.02). Nausea and vomiting were significantly lower in patients receiving diazepam after 2 and 6 hours (P=0.02 & P=0.03).No statistically significant differences were found between the groups in nistagmus, equilibrium & vertigo duration. Conclusion: The results of this randomized trial showed that both drugs had acceptable therapeutic effects in peripheral vertigo, although betahistine was significantly more efficacious after 4 hours of drug intake. As for higher nausea and vomiting in betahistine group, physician should consider these side effects before drug prescription.

Keywords: acute peripheral vertigo, betahistine, diazepam, emergency department

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621 The Overlooked Problem Among Surgical Patients: Preoperative Anxiety at Ethiopian University Hospital

Authors: Yohtahe Woldegerima Berhe, Tadesse Belayneh Melkie, Girmay Fitiwi Lema, Marye Getnet, Wubie Birlie Chekol

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Introduction: Anxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methodology: Hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by the State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. The strength of association was described in adjusted odds ratio (AOR) and a p-value < 0.05 at a 95% confidence interval which was considered statistically significant. Results: A total of 400 patients were included in this study, with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40 – 56.7). age ≥ 60 years (AOR: 5.7, CI: 1.6 – 20.4, P: 0.007), emergency surgery (AOR: 2.5, CI: 1.3 – 4.7, P: 0.005), preoperative pain (AOR: 2.6, CI: 1.2 – 5.4, P: 0.005), and rural residency (AOR: 1.8, CI: 1.1 – 2.9, P: 0.031) were found significantly associated with preoperative anxiety. Conclusions: The prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found to be significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.

Keywords: preoperative anxiety, anxiety, anxiety of anesthesia and surgery, state-trait anxiety inventory, preoperative care

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620 Planning Water Reservoirs as Complementary Habitats for Waterbirds

Authors: Tamar Trop, Ido Izhaki

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Small natural freshwater bodies (SNFWBs), which are vital for many waterbird species, are considered endangered habitats due to their progressive loss and extensive degradation. While SNFWBs are becoming extinct, studies have indicated that many waterbird species may greatly benefit from various types of small artificial waterbodies (SAWBs), such as floodwater and treated water reservoirs. If designed and managed with care, SAWBs hold significant potential to serve as alternative or complementary habitats for birds, and thus mitigate the adverse effects of SNFWBs loss. Currently, most reservoirs are built as infrastructural facilities and designed according to engineering best practices and site-specific considerations, which do not include catering for waterbirds' needs. Furthermore, as things stand, there is still a lack of clear and comprehensive knowledge regarding the additional factors that should be considered in tackling the challenge of attracting waterbirds' to reservoirs, without compromising on the reservoirs' original functions. This study attempts to narrow this knowledge gap by performing a systematic review of the various factors (e.g., bird attributes; physical, structural, spatial, climatic, chemical, and biological characteristics of the waterbody; and anthropogenic activities) affecting the occurrence, abundance, richness, and diversity of waterbirds in SNFWBs. The methodical review provides a concise and relatively unbiased synthesis of the knowledge in the field, which can inform decision-making and practice regarding the planning, design, and management of reservoirs with birds in mind. Such knowledge is especially beneficial for arid and semiarid areas, where natural water sources are deteriorating and becoming extinct even faster due to climate change.

Keywords: artificial waterbodies, reservoirs, small waterbodies, waterbirds

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619 Maternal Health Care Utilization and Its Effect on Pregnancy Outcome in Nepal

Authors: Adrita Banerjee, Ajeet Kumar Singh

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Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

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618 Bio-Estimation of Selected Heavy Metals in Shellfish and Their Surrounding Environmental Media

Authors: Ebeed A. Saleh, Kadry M. Sadek, Safaa H. Ghorbal

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Due to the determination of the pollution status of fresh resources in the Egyptian territorial waters is very important for public health, this study was carried out to reveal the levels of heavy metals in the shellfish and their environment and its relation to the highly developed industrial activities in those areas. A total of 100 shellfish samples from the Rosetta, Edku, El-Maadiya, Abo-Kir and El-Max coasts [10 crustaceans (shrimp) and 10 mollusks (oysters)] were randomly collected from each coast. Additionally, 10 samples from both the water and the sediment were collected from each coast. Each collected sample was analyzed for cadmium, chromium, copper, lead and zinc residues using a Perkin Elmer atomic absorption spectrophotometer (AAS). The results showed that the levels of heavy metals were higher in the water and sediment from Abo-Kir. The heavy metal levels decreased successively for the Rosetta, Edku, El-Maadiya, and El-Max coasts, and the concentrations of heavy metals, except copper and zinc, in shellfish exhibited the same pattern. For the concentration of heavy metals in shellfish tissue, the highest was zinc and the concentrations decreased successively for copper, lead, chromium and cadmium for all coasts, except the Abo-Kir coast, where the chromium level was highest and the other metals decreased successively for zinc, copper, lead and cadmium. In Rosetta, chromium was higher only in the mollusks, while the level of this metal was lower in the crustaceans; this trend was observed at the Edku, El-Maadiya and El-Max coasts as well. Herein, we discuss the importance of such contamination for public health and the sources of shellfish contamination with heavy metals. We suggest measures to minimize and prevent these pollutants in the aquatic environment and, furthermore, how to protect humans from excessive intake.

Keywords: atomic absorption, heavy metals, sediment, shellfish, water

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617 Techniques of Construction Management in Civil Engineering

Authors: Mamoon M. Atout

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The Middle East Gulf region has witnessed rapid growth and development in many areas over the last two decades. The development of the real-estate sector, construction industry and infrastructure projects are a major share of the development that has participated in the civilization of the countries of the Gulf. Construction industry projects were planned and managed by different types of experts, who came from all over the world having different types of experiences in construction management and industry. Some of these projects were completed on time, while many were not, due to many accumulating factors. Many accumulated factors are considered as the principle reason for the problem experienced at the project construction stage, which reflected negatively on the project success. Specific causes of delay have been identified by construction managers to avoid any unexpected delays through proper analysis and considerations to some implications such as risk assessment and analysis for many potential problems to ensure that projects will be delivered on time. Construction management implications were adopted and considered by project managers who have experience and knowledge in applying the techniques of the system of engineering construction management. The aim of this research is to determine the benefits of the implications of construction management by the construction team and level of considerations of the techniques and processes during the project development and construction phases to avoid any delay in the projects. It also aims to determine the factors that participate to project completion delays in case project managers are not well committed to their roles and responsibilities. The results of the analysis will determine the necessity of the applications required by the project team to avoid the causes of delays that help them deliver projects on time, e.g. verifying tender documents, quantities and preparing the construction method of the project.

Keywords: construction management, control process, cost control, planning and scheduling

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616 Comparison of Growth Medium Efficiency into Stevia (Stevia rebaudiana Bertoni) Shoot Biomass and Stevioside Content in Thin-Layer System, TIS RITA® Bioreactor, and Bubble Column Bioreactor

Authors: Nurhayati Br Tarigan, Rizkita Rachmi Esyanti

Abstract:

Stevia (Stevia rebaudiana Bertoni) has a great potential to be used as a natural sweetener because it contains steviol glycoside, which is approximately 100 - 300 times sweeter than sucrose, yet low calories. Vegetative and generative propagation of S. rebaudiana is inefficient to produce stevia biomass and stevioside. One of alternative for stevia propagation is in vitro shoot culture. This research was conducted to optimize the best medium for shoot growth and to compare the bioconversion efficiency and stevioside production of S. rebaudiana shoot culture cultivated in thin layer culture (TLC), recipient for automated temporary immersion system (TIS RITA®) bioreactor, and bubble column bioreactor. The result showed that 1 ppm of Kinetin produced a healthy shoot and the highest number of leaves compared to BAP. Shoots were then cultivated in TLC, TIS RITA® bioreactor, and bubble column bioreactor. Growth medium efficiency was determined by yield and productivity. TLC produced the highest growth medium efficiency of S. rebaudiana, the yield was 0.471 ± 0.117 gbiomass.gsubstrate-1, and the productivity was 0.599 ± 0.122 gbiomass.Lmedium-1.day-1. While TIS RITA® bioreactor produced the lowest yield and productivity, 0.182 ± 0.024 gbiomass.gsubstrate-1 and 0.041 ± 0.0002 gbiomass.Lmedium-1.day-1 respectively. The yield of bubble column bioreactor was 0.354 ± 0.204 gbiomass.gsubstrate-1 and the productivity was 0,099 ± 0,009 gbiomass.Lmedium-1.day-1. The stevioside content from the highest to the lowest was obtained from stevia shoot which was cultivated on TLC, TIS RITA® bioreactor, and bubble column bioreactor; the content was 93,44 μg/g, 42,57 μg/g, and 23,03 μg/g respectively. All three systems could be used to produce stevia shoot biomass, but optimization on the number of nutrition and oxygen intake was required in each system.

Keywords: bubble column, growth medium efficiency, Stevia rebaudiana, stevioside, TIS RITA®, TLC

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615 Exploring Psychosocial Factors That Enable Teachers to Cope with Workplace Adversity at a Rural District School Setting

Authors: K. R. Mukuna

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Teachers are faced many challenges in the South African rural schools such as stress, depression, lack of resources, poor working relationships, inflexible curriculum etc. These could affect their wellbeing and effectiveness at the workplace. As a result, the study had a significance in the teacher’s lives, and community due teachers worked under conditions that are unfavourable to perform their jobs effectively. Despite these conditions, they still managed to do their jobs and the community is uplifted. However, this study aimed to explore factors that enable teachers to cope with workplace adversities at a rural school district in the Free State Province. It adopted a qualitative case study as a research design. Semi-structured interviews and colleges had employed as tools to collect data. Ten participants (n=10; 5 males and 5 females) were selected through purposive and convenience sampling. All participants selected from a South African rural school. Sesotho culture was their home language, and most of them had 5 years of teaching experiences. The thematic findings revealed that they developed abilities to cope with and adjust to the social and cultural environment. These included self-efficacy, developing problem-solving skills, awareness of strengths and asserts, self-managing of emotions, and self-confidence. This study concluded that these psychosocial factors contributed to coping with teacher’s diversities, and effectively stabilized their wellbeing in the schools.

Keywords: psychosocial factors, teachers counselling, teacher stress, workplace adversity, rural school, teachers’ wellbeing, teachers’ resilience, teachers’ self-efficacy, social interaction

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614 Dielectric Properties of Mineral Oil Blended with Soyabean Oil for Power Transformers: A Laboratory Investigation

Authors: Deepa S N, Srinivasan a D, Veeramanju K T

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The power transformer is a critical equipment in the transmission and distribution network that must be managed to ensure uninterrupted power service. The liquid insulation is essential for the proper functioning of the transformer, as it serves as both coolant and insulating medium, which influences the transformer’s durability. Further, the insulating state of a power transformer has a significant impact on its reliability. Mineral oil derived from petroleum crude oil has been employed as liquid dielectrics for decades due to its superior functional characteristics, however as a resource for the same are getting depleted over the years. Research is undertaken across the globe to identify a viable substitute for mineral oil. Further, alternate insulating oils are being investigated for better environmental impact, biodegradability and economics. Several combinations of vegetable oil derived natural esters are being inspected by researchers across the globe in these domains. In this work, mineral oil is blended with soyabean oil with various proportions and dielectric properties such as dielectric breakdown voltage, relative permittivity, dissipation factor, viscosity, flash and fire point have been investigated according to international standards. A quantitative comparison is made among various samples and is observed that the blended oil sample of equal proportion of mineral oil and soyabean oil, MO50+SO50 exhibits superior dielectric properties such as breakdown voltage of 65kV, dissipation factor of 0.0044, relative permittivity of 3.1680 that are closer to the range of values recommended for power transformer applications. Also, Breakdown voltage values of all the investigated oil samples obeyed the Weibull and Normal probability distribution.

Keywords: blended oil, dielectric breakdown, liquid insulation, power transformer

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613 Constructing Masculinity through Images: Content Analysis of Lifestyle Magazines in Croatia

Authors: Marija Lončar, Zorana Šuljug Vučica, Magdalena Nigoević

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Diverse social, cultural and economic trends and changes in contemporary societies influence the ways masculinity is represented in a variety of media. Masculinity is constructed within media images as a dynamic process that changes slowly over time and is shaped by various social factors. In many societies, dominant masculinity is still associated with authority, heterosexuality, marriage, professional and financial success, ethnic dominance and physical strength. But contemporary media depict men in ways that suggest a change in the approach to media images. The number of media images of men, which promote men’s identity through their body, have increased. With the male body more scrutinized and commodified, it is necessary to highlight how the body is represented and which visual elements are crucial since the body has an important role in the construction of masculinities. The study includes content analysis of male body images in the advertisements of different men’s and women’s lifestyle magazines available in Croatia. The main aim was to explore how masculinities are currently being portrayed through body regarding age, physical appearance, fashion, touch and gaze. The findings are also discussed in relation to female images since women are central in many of the processes constructing masculinities and according to the recent conceptualization of masculinity. Although the construction of male images varies through body features, almost all of them convey the message that men’s identity could be managed through manipulation and by enhancing the appearance. Furthermore, they suggest that men should engage in “bodywork” through advertised products, activities and/or practices, in order to achieve their preferred social image.

Keywords: body images, content analysis, lifestyle magazines, masculinity

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612 Management of Renal Malignancies with IVC Thrombus: Our Experience

Authors: Sujeet Poudyal

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Introduction: Renal cell carcinoma is the most common malignancy associated with Inferior vena cava (IVC) thrombosis. Radical nephrectomy with tumor thrombectomy provides durable cancer-free survival. Other renal malignancies like Wilms’ tumors are also associated with IVC thrombus. We describe our experience with the management of renal malignancies associated with IVC thrombus. Methods: This prospective study included 28 patients undergoing surgery for renal malignancies associated with IVC thrombus from February 2017 to March 2023. Demographics of patients, types of renal malignancy, level of IVC thrombus, intraoperative details, need for venovenous bypass, cardiopulmonary bypass and postoperative outcomes were all documented. Results: Out of a total of 28 patients, 24 patients had clear cell Renal Cell Carcinoma,1 had renal osteosarcoma and 3 patients had Wilms tumor. The levels. of thrombus were II in eight, III in seven, and IV in six patients. The mean age of RCC was 62.81±10.2 years, renal osteosarcoma was 26 years and Wilms tumor was 23 years. There was a need for venovenous bypass in four patients and cardiopulmonary bypass in four patients, and the Postoperative period was uneventful in most cases except for two mortalities, one in Level III due to pneumonia and one in Level IV due to sepsis. All cases followed up till now have no local recurrence and metastasis except one case of RCC with Level IV IVC thrombus, which presented with paraaortic nodal recurrence and is currently managed with sunitinib. Conclusion: The complexity in the management of renal malignancy with IVC thrombus increases with the level of IVC thrombus. As radical nephrectomy with tumor thrombectomy provides durable cancer-free survival in most cases, the surgery should be undertaken in an expert and experienced setup with a strong cardiovascular backup to minimize morbidity and mortality associated with the procedure.

Keywords: renal malignancy, IVC thrombus, radical nephrectomy with tumor thrombectomy, renal cell carcinoma

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611 Potentials of Henna Leaves as Dye and Its Fastness Properties on Fabric

Authors: Nkem Angela Udeani

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Despite the widespread use of synthetic dyes, natural dyes are still exploited and used to enhance its inherent aesthetic qualities as a major material for the beautification of the body. Centuries before the discovery of synthetic dye, natural dyes were the only source of dye open to mankind. Dyes are extracted from plant - leaves, roots, and barks, insect secretions, and minerals. However, research findings have made it clear that of all, plant- leaves, roots, barks or flowers are the most explored and exploited. Henna (Lawsonia innermis) is one of those plants. The experiment has also shown that henna is used in body painting in conjunction with an alkaline (Ammonium Sulphate) as a fixing agent. This of course gives a clue that if colour derived from henna is properly investigated, it may not only be used as body decoration but possibly, may have affinity to fibre substrate. This paper investigates the dyeing potentials - dyeing ability and fastness qualities of henna dye extract on cotton and linen fibres using mordants like ammonium sulphate and other alkalies (hydrosulphate and caustic soda, potash, common salt and alum). Hot and cold water and ethanol solvent were used in the extraction of the dye to investigate the most effective method of extraction, dyeing ability and fastness qualities of these extracts under room temperature. The results of the experiment show that cotton have a high rate of dye intake than linen fibre. On a similar note, the colours obtained depend most on the solvent and or the mordant used. In conclusion, hot water extraction appear more effective. While the colours obtained from ethanol and both cold and hot method of extraction range from light to dark yellow, light green to army green, there are to some extent shades of brown hues.

Keywords: dye, fabrics, henna leaves, potential

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610 Community Forest Management and Ecological and Economic Sustainability: A Two-Way Street

Authors: Sony Baral, Harald Vacik

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This study analyzes the sustainability of community forest management in two community forests in Terai and Hills of Nepal, representing four forest types: 1) Shorearobusta, 2) Terai hardwood, 3) Schima-Castanopsis, and 4) other Hills. The sustainability goals for this region include maintaining and enhancing the forest stocks. Considering this, we analysed changes in species composition, stand density, growing stock volume, and growth-to-removal ratio at 3-5 year intervals from 2005-2016 within 109 permanent forest plots (57 in the Terai and 52 in the Hills). To complement inventory data, forest users, forest committee members, and forest officials were consulted. The results indicate that the relative representation of economically valuable tree species has increased. Based on trends in stand density, both forests are being sustainably managed. Pole-sized trees dominated the diameter distribution, however, with a limited number of mature trees and declined regeneration. The forests were over-harvested until 2013 but under-harvested in the recent period in the Hills. In contrast, both forest types were under-harvested throughout the inventory period in the Terai. We found that the ecological dimension of sustainable forest management is strongly achieved while the economic dimension is lacking behind the current potential. Thus, we conclude that maintaining a large number of trees in the forest does not necessarily ensure both ecological and economical sustainability. Instead, priority should be given on a rational estimation of the annual harvest rates to enhance forest resource conditions together with regular benefits to the local communities.

Keywords: community forests, diversity, growing stock, forest management, sustainability, nepal

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609 Central Finite Volume Methods Applied in Relativistic Magnetohydrodynamics: Applications in Disks and Jets

Authors: Raphael de Oliveira Garcia, Samuel Rocha de Oliveira

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We have developed a new computer program in Fortran 90, in order to obtain numerical solutions of a system of Relativistic Magnetohydrodynamics partial differential equations with predetermined gravitation (GRMHD), capable of simulating the formation of relativistic jets from the accretion disk of matter up to his ejection. Initially we carried out a study on numerical methods of unidimensional Finite Volume, namely Lax-Friedrichs, Lax-Wendroff, Nessyahu-Tadmor method and Godunov methods dependent on Riemann problems, applied to equations Euler in order to verify their main features and make comparisons among those methods. It was then implemented the method of Finite Volume Centered of Nessyahu-Tadmor, a numerical schemes that has a formulation free and without dimensional separation of Riemann problem solvers, even in two or more spatial dimensions, at this point, already applied in equations GRMHD. Finally, the Nessyahu-Tadmor method was possible to obtain stable numerical solutions - without spurious oscillations or excessive dissipation - from the magnetized accretion disk process in rotation with respect to a central black hole (BH) Schwarzschild and immersed in a magnetosphere, for the ejection of matter in the form of jet over a distance of fourteen times the radius of the BH, a record in terms of astrophysical simulation of this kind. Also in our simulations, we managed to get substructures jets. A great advantage obtained was that, with the our code, we got simulate GRMHD equations in a simple personal computer.

Keywords: finite volume methods, central schemes, fortran 90, relativistic astrophysics, jet

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608 Interspecific Competition among Three Fruit Fly Species Infesting Watermelon and Zucchini (Cucurbitaceae)

Authors: Gbenonsi A. Fabrice, Mama Sambo Sahadatou, Layode B. F. Rodolphe, Totin A. Felicien, Onzo Alexis, Karlsson M. Frida

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Interspecific competition occurs among arthropod pest species that share hosts, thereby influencing their population dynamics. In sub-Saharan Africa, the native fruit fly species Dacus vertebratus (Bezzi) and Dacus ciliatus (Loew) (Diptera: Tephritidae) and the exotic Zeugodacus cucurbitae (Coquillett) are concurrent pests in the same host fruits; hence competition among them is likely to occur. We explored interspecific competition among these three fruit fly species on zucchini (Cucurbita pepo L.) and watermelon (Citrullus lanatus Thunb) (Cucurbitaceae) to improve our understanding of the interaction between the species and their capacity to coexist. We exposed the vegetable fruits to different densities of fruit fly species and studied their behavioural activities, evaluating the extrinsic competition. To assess intrinsic competition and understand the effect of co-occurrence inside the fruits, eggs of the three fruit flies were pairwise inoculated into the same fruits. Results showed that the behaviour on the fruits differed between the species and that the interspecific competition affected their developmental time and larval survival in both watermelon and zucchini. Z. cucurbitae were more aggressive than the other species and managed to oviposit more frequently. Emergence was reduced for D. ciliatus and D. vertebratus when inoculated together with Z. cucurbitae in watermelon but not in zucchini. Physical confrontations were more common in zucchini than in watermelon and were more frequently won by Z. cucurbitae than D. vertebratus and D. ciliatus. Interspecific competition information obtained about behavioural differences and interaction effects, providing background for explaining the present fruit fly guild on certain Cucurbitaceae fruits in West Africa.

Keywords: behavioural activities, extrinsic competition, intrinsic competition, Tephritidae

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607 Understanding Solid Waste Management in Face of Political Instability: Actors, Roles, and Challenges to Sustainable Development in Kinshasa

Authors: Longondjo Etambakonga Clement

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Local municipality responsible for solid waste management (SWM) in many developing countries is facing real challenge. This is even more critical in the country facing political instability. Few decades ago, it has emerged new urban governance including partnerships and involvement of formal and informal actors for an effective and sustainable solid waste management. This paper identifies SWM actors and analyzes their roles to sustainable development in Kinshasa. An attempt has been to examine the challenges facing the actors in managing effectively waste in the city. The study is based on the empirical data gathered in the years 2009 and 2014 in Kinshasa using expert interviews, observation and documentation. The findings indicate that solid waste in the city is poorly managed, activities not coordinated and fragmented, as consequence severe public health and environmental problems. Five group actors are involved in SWM in the city including government, private business, NGOs/CBOs/donors, household, scavengers, in which, scavengers are more visible in collection and recycling activities. The results suggest that recognition of informal collectors and recyclers (scavengers) and strengthening alliances among all SWM stakeholders can lead to greater effective SWM in the city. The key lessons learned include lack of city’s SWM culture over SWM, unwillingness to pay and lack of environmental consciences are the main obstructions to sustainable SWM, therefore there is a need for social capital approach to empower individual and group actors as to create capabilities for an sustainable SWM.

Keywords: challenges, institutions, political instability, scavengers, solid waste management, sustainable development

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606 Experimental Study on Two-Step Pyrolysis of Automotive Shredder Residue

Authors: Letizia Marchetti, Federica Annunzi, Federico Fiorini, Cristiano Nicolella

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Automotive shredder residue (ASR) is a mixture of waste that makes up 20-25% of end-of-life vehicles. For many years, ASR was commonly disposed of in landfills or incinerated, causing serious environmental problems. Nowadays, thermochemical treatments are a promising alternative, although the heterogeneity of ASR still poses some challenges. One of the emerging thermochemical treatments for ASR is pyrolysis, which promotes the decomposition of long polymeric chains by providing heat in the absence of an oxidizing agent. In this way, pyrolysis promotes the conversion of ASR into solid, liquid, and gaseous phases. This work aims to improve the performance of a two-step pyrolysis process. After the characterization of the analysed ASR, the focus is on determining the effects of residence time on product yields and gas composition. A batch experimental setup that reproduces the entire process was used. The setup consists of three sections: the pyrolysis section (made of two reactors), the separation section, and the analysis section. Two different residence times were investigated to find suitable conditions for the first sample of ASR. These first tests showed that the products obtained were more sensitive to residence time in the second reactor. Indeed, slightly increasing residence time in the second reactor managed to raise the yield of gas and carbon residue and decrease the yield of liquid fraction. Then, to test the versatility of the setup, the same conditions were applied to a different sample of ASR coming from a different chemical plant. The comparison between the two ASR samples shows that similar product yields and compositions are obtained using the same setup.

Keywords: automotive shredder residue, experimental tests, heterogeneity, product yields, two-step pyrolysis

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605 Possible Modulation of FAS and PTP-1B Signaling in Ameliorative Potential of Bombax ceiba against High Fat Diet Induced Obesity

Authors: Paras Gupta, Rohit Goyal, Yamini Chauhan, Pyare Lal Sharma

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Background: Bombax ceiba Linn., commonly called as Semal, is used in various gastro-intestinal disturbances. It contains lupeol which inhibits PTP-1B, adipogenesis, TG synthesis and accumulation of lipids in adipocytes and adipokines whereas the flavonoids isolated from B. ceiba has FAS inhibitory activity. The present study was aimed to investigate ameliorative potential of Bombax ceiba to experimental obesity in Wistar rats, and its possible mechanism of action. Methods: Male Wistar albino rats weighing 180–220 g were employed in present study. Experimental obesity was induced by feeding high fat diet for 10 weeks. Methanolic extract of B. ceiba extract 100, 200 and 400 mg/kg and Gemfibrozil 50 mg/kg as standard drug were given orally from 7th to 10th week. Results: Induction with HFD for 10 weeks caused significant (p < 0.05) increase in % body wt, BMI, LEE indices; serum glucose, triglyceride, LDL, VLDL, cholesterol, free fatty acid, ALT, AST; tissue TBARS, nitrate/nitrite levels; different fat pads and relative liver weight; and significant decrease in food intake (g and kcal), serum HDL and tissue glutathione levels in HFD control rats. Treatment with B. ceiba extract and Gemfibrozil significantly attenuated these HFD induced changes, as compared to HFD control. The effect of B. ceiba 200 and 400 mg/kg was more pronounced in comparison to Gemfibrozil. Conclusion: On the basis of results obtained, it may be concluded that the methanolic extract of stem bark of Bombax ceiba has significant ameliorative potential against HFD induced obesity in rats, possibly through modulation of FAS and PTP-1B signaling due to the presence of flavonoids and lupeol.

Keywords: obesity, Bombax ceiba, free fatty acid, protein tyrosine phosphatase-1B, fatty acid synthase

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604 Sustainable Tourism a Challenge to Competitivity: OBSERVE Project

Authors: Rui Lança, Elisa Silva, Fátima Farinha, Miguel José Oliveira, Manuel Duarte Pinheiro, Cátia Miguel

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Tourism has a great potential to bring up progress across the Sustainable Development Goals (SDGs). If well managed and monitored, the tourism sector can create quality jobs, reduce poorness and offer incentives for environmental preservation, helping on the transition towards more inclusive and resilient economies. However, without proper safeguards and investments, expansion of the tourism market will increase pressure on biodiversity and the ecosystems on which the livelihoods of local communities depend. Competitivity is a key dimension in tourism, sustainable tourism challenge new dimensions to competitivity, namely environmental, social, institutional and economic achieve a medium and long-term competitivity. It is undoubtedly clear on the tourism sector, the importance of the region sustainability in the current touristic destinations offer. The basis of a tourism region prosperity will depend on /of it. The OBSERVE project intends to be an instrument for monitoring and evaluating the sustainability levels of the Algarve region. Its main objective is to provide environmental, economic, social-cultural and institutional indicators to support the decision-making process for a sustainable growth of the region. The project´s main goal is a digital portal with the most relevant indicators to allow evaluating and communicating the performance of the region in a sustainable growth perspective. This paper presents the OBSERVE project and highlights the potential contribution to a broad perspective of competitivity and its contribution for different stakeholders and the touristic value chain. Limitations and opportunities are also discussed.

Keywords: sustainable tourism, competitivity, OBSERVE project, Algarve region

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603 Investigation of the Functional Impact of Amblyopia on Visual Skills in Children

Authors: Chinmay V. Deshpande

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Purpose: To assess the efficiency of visual functions and visual skills in strabismic & anisometropic amblyopes and to assess visual acuity and contrast sensitivity in anisometropic amblyopes with spectacles & contact lenses. Method: In a prospective clinical study, 32 children ageing from 5 to 15 years presenting with amblyopia in a pediatric department of Shri Ganapati Netralaya Jalna, India, were assessed for a period of three & half months. Visual acuity was measured with Snellen’s and Bailey-Lovie log MAR charts whereas contrast sensitivity was measured with Pelli-Robson chart with spectacles and contact lenses. Saccadic movements were assessed with SCCO scoring criteria and accommodative facility was checked with ±1.50 DS flippers. Stereopsis was assessed with TNO test. Results: By using Wilcoxon sign rank test p-value < 0.05 (< 0.001), the mean linear visual acuity was 0.29 (≈ 6/21) and mean single optotype visual acuity found to be 0.36 (≈ 6/18). Mean visual acuity of 0.27(≈ 6/21) with spectacles improved to 0.33 (≈ 6/18) with contact lenses in amblyopic eyes. The mean Log MAR visual acuity with spectacles and contact lens were found to be 0.602( ≈6/24) and 0.531(≈ 6/21) respectively. The contrast threshold out of 20 amblyopic eyes shows that mean contrast threshold changed in 9 patients from spectacles 0.27 to contact lens 0.19 respectively. The mean accommodative facility assessed was 5.31(± 2.37). 24 subjects (75%) revealed marked saccadic defects on the test applied. 78% subjects didn’t show even gross stereoscopic ability on TNO test. Conclusion: This study supports the facts about amblyopia and associated deficits in visual skills which are claimed in previous studies. In addition, anisometropic amblyopia can be managed better with contact lenses.

Keywords: strabismus, anisometropia, amblyopia, contrast sensitivity, saccades, stereopsis

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602 Assessment of Germination Loss Due to Dusky Cotton Bug (Oxycarenus laetus) in Relation to Cotton Boll Stage and Bug Intensity

Authors: Ali Hassan, Mian Muhammad Awais, Muhammad Rafique Shahid, Farazia Hassan, Shumaila Rasool

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Dusky cotton bug (Oxycarenus laetus) has attained the status of major insect pest of cotton. It is also known as seed bug due to its property of feeding on seeds. It causes floral abscission at flowering stage and reduction in seed germination. Present study was carried out to assess germination loss caused by dusky bug with respect to crop stage and insect intensity. Treatments consisted of three stages immature boll, mature boll and opened boll as well three levels of dusky bug i.e., 50 bugs per boll, 40 bugs per boll along with zero level kept as control. Results showed that the germination percentage was highest in control treatment where no insect was released followed by treatment where 40 insects released and minimum germination showed by treatment in which 50 insects were released. The germination percentage of seeds surpassed after control treatment in the treatment where dusky bugs exposure was given at boll opening stage than on mature boll stage. Minimum germination was observed in immature boll stage. Interaction between crop stages and dusky bug levels showed that germination percentage of seeds was maximum in control treatment then boll opening stage followed by mature boll stage. Minimum seed germination was recorded in dusky bug treatment at immature boll stage which was 34% where 50 insects were released. From the results it is clear that dusky bug should be managed properly at all reproductive stages but immature stage is most critical.

Keywords: Gossypium hirsutum, Oxycarenus laetus, seed bug, seed germination

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601 The Taxonomic and Functional Diversity in Edaphic Microbial Communities from Antarctic Dry Valleys

Authors: Sean T. S. Wei, Joy D. Van Nostrand, Annapoorna Maitrayee Ganeshram, Stephen B. Pointing

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McMurdo Dry Valleys are a largely ice-free polar desert protected by international treaty as an Antarctic special managed area. The terrestrial landscape is dominated by oligotrophic mineral soil with extensive rocky outcrops. Several environmental stresses: low temperature, lack of liquid water, UV exposure and oligotrophic substrates, restrict the major biotic component to microorganisms. The bacterial diversity and the putative physiological capacity of microbial communities of quartz rocks (hypoliths) and soil of a maritime-influenced Dry Valleys were interrogated by two metagenomic approaches: 454 pyro-sequencing and Geochp DNA microarray. The most abundant phylum in hypoliths was Cyanobacteria (46%), whereas in solils Actinobacteria (31%) were most abundant. The Proteobacteria and Bacteriodetes were the only other phyla to comprise >10% of both communities. Carbon fixation was indicated by photoautotrophic and chemoautotrophic pathways for both hypolith and soil communities. The fungi accounted for polymer carbon transformations, particularly for aromatic compounds. The complete nitrogen cycling was observed in both communities. The fungi in particular displayed pathways related to ammonification. Environmental stress response pathways were common among bacteria, whereas the nutrient stress response pathways were more widely present in bacteria, archaea and fungi. The diversity of bacterialphage was also surveyed by Geochip. Data suggested that different substrates supported different viral families: Leviviridae, Myoviridae, Podoviridae and Siphoviridiae were ubiquitous. However, Corticoviridae and Microviridae only occurred in wetter soils.

Keywords: Antarctica, hypolith, soil, dry valleys, geochip, functional diversity, stress response

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600 Protective Effect of Vitamin D on Cardiac Apoptosis in Obese Rats

Authors: Kadeejah Alsolami, Zainab Alrefay, Husaam Awad

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Obesity and vitamin D deficiency have both been related to cardiovascular disease. The present work aimed to investigate the possible protective effect of vitamin D on cardiac apoptosis in a rat model of dietary-induced obesity. Methods: 30 male Wistar rats included in this study. They were allocated into 4 groups: Control (n=5), animal were fed standard diet for 3 months: Control + vitamin D (VD) (n=5),animals were fed a standard diet with 400IU VD/kg for 3 months: hypercaloric diets group (n=10), animals were fed a high fat diet for 3 months: hypercaloric diet with VD group (n=10), animals were fed a high fat diet with 400IU VD/kg for 3 months. At the beginning of the experiment, the weight and length were measured to assess body mass index (BMI) and repeated every 45 days. Food intake and body weight were monitored throughout the study period. Then rats were sacrificed and heart tissues collected for Quantitative Real-time polymerase chain reaction (qRT-PCR). qRT-PCR used to detect different genetic markers of apoptosis (anti-apoptotic gene (BCL2), a pro-apoptotic gene(BAX), pro-apoptotic genes (FAS, FAS-L), tumour necrosis factor (TNF), mitogen-activated protein kinases (MAPK). Results: FAS and FAS-L gene expression were significantly upregulated in rats fed with high fat diet. And FAS-L gene expression was significantly upregulated in all groups on comparison with control. Whereas Bax gene expression was significantly downregulated in rats fed with high-fat diet supplied with vitamin D. TNF was significantly upregulated in rats fed with high-fat diet treated with vitamin D. MAPK was significantly upregulated in rats fed with high fat diet group, and in rats fed with high-fat diet supplied with vitamin D. Conclusion: The cardiac apoptotic pathways were more activated in rats fed with high-fat than lean rats. And vitamin D protect the heart from the cardiac mitochondrial-dependent apoptotic pathway.

Keywords: apoptosis, heart, obesity, Vitamin D

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599 Swallowing Outcomes in Supraglottic Cancer Patients after Trans-Oral Robotic Surgery (TORS) Provided with Early Dysphagia Management Using Standardized Functional and Objective Measures

Authors: Hitesh Gupta, Surender Dabas

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TORS is increasingly gaining widespread use and has been explored as minimally invasive surgery for the treatment of supraglottic cancer (SGC). Being a central critical role of Supraglottis in deglutition, swallowing outcomes post TORS remain a most important factor. Available published studies show inconsistent swallowing outcomes and are deficient in standardized outcome measures, description of swallowing recovery and rehabilitation. So, the objective of this study is to find out swallowing outcomes in SGC patients after TORS provided with early dysphagia management using standardized measures. Prospectively 16 patients were recruited in the study who underwent TORS for primary tumor of Supraglottis, involving one or more sub-sites or invading to sites other than Supraglottis at the BLK Super Specialty Hospital, New Delhi from March 2019 to June 2020. All patients were evaluated for dysphagia with subsequent swallowing rehabilitation on post operative day 3 in the hospital or at the time of discharge, whichever was earlier. Functional oral intake scale (FOIS) and penetration-aspiration score (PAS) were used as outcome measures to quantify swallowing recovery at one month and six month post operatively. Post TORS, patients achieved functional swallow in less than one month, where resection was limited to Supraglottis, while the recovery was delayed in patients with extended resection to tongue base or hypopharynx. Overall, out of Total 16 cases including all supraglottis sub-catagories, 13 (81%) could remove their NG tube (FOIS ≥5 and PAS=1 ) within 6 months. In which 8 cases(62%) achieved functional swallow in less than one month. Swallowing outcomes post TORS supraglottic laryngectomy are favorable if provided with early dysphagia management (or swallowing rehabilitation).

Keywords: dysphagia, supraglottic cancer, swallowing, TORS

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598 Beyond Juridical Approaches: The Role of Sociological Approach in Promoting Human Rights of Migrants

Authors: Ali Aghahosseini Dehaghani

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Every year in this globalized world, thousands of migrants leave their countries hoping to find a better situation of life in other parts of the world. In this regard, many questions, from a human rights point of view, have been raised about how this phenomenon should be managed in the host countries. Although legal approaches such as legislation and litigation are inevitable in the way to respect the human rights of migrants, there is an increasing consensus about the fact that a strict juridical approach is inadequate to protect as well as to prevent violations of migrants’ rights. Indeed, given the multiplicity of factors that affect and shape the application of these rights and considering the fact that law is a social phenomenon, what is needed is an interdisciplinary approach, which combines both juridical approaches and perspectives from other disciplines. In this respect, a sociological approach is important because it shows the social processes through which human rights of migrants have been constructed or violated in particular social situations. Sociologists who study international migration ask the questions such as how many people migrate, who migrates, why people migrate, what happens to them once they arrive in the host country, how migration affects sending and receiving communities, the extent to which migrants help the economy, the effects of migration on crimes, and how migrants change the local communities. This paper is an attempt to show how sociology can promote human rights of migrants. To this end, the article first explores the usefulness and value of an interdisciplinary approach to realize how and to what extent sociology may improve and promote the human rights of migrants in the destination country. It then examines mechanisms which help to reach to a systematic integration of law and sociological discipline to advance migrants’ rights as well as to encourage legal scholars to consider the implications of societal structures in their works.

Keywords: human rights, migrants, sociological approach, interdisciplinary study

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597 Response of Grower Turkeys to Diets Containing Moringa oleifera Leaf Meal in a Tropical Environment

Authors: Augustine O. Ani, Ifeyinwa E. Ezemagu, Eunice A. Akuru

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A seven-week study was conducted to evaluate the response of grower turkeys to varying dietary levels of Moringa oleifera leaf meal (MOLM) in a humid tropical environment. A total of 90 twelve weeks old male and female grower turkeys were randomly divided into five groups of 18 birds each in a completely randomized design (CRD) and assigned to five caloric (2.57-2.60 Mcal/kg ME) and isonitrogenous (19.95% crude protein) diets containing five levels (0, 15, 20, 25 and 30%) of MOLM, respectively. Each treatment was replicated three times with 6 birds per replicate housed in a deep litter pen of fresh wood shavings measuring 1.50m x 1.50m. Feed and water were provided to the birds' ad libitum. Parameters measured were: final live weight (FLW) daily weight gain (DWG), daily feed intake (DFI), feed conversion ratio (FCR), protein efficiency ratio (PER), packed cell volume (PCV), haemoglobin concentration (Hb), red blood cell (RBC) count, white blood cell (WBC) count, mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC), feed cost / kg weight gain and apparent nutrient retention. Results showed that grower turkeys fed 20% MOLM diet had significantly (p < 0.05) higher FLW and DWG values (4410.30 g and 34.49 g, respectively) and higher DM and NFE retention values (67.28 and 58.12%, respectively) than turkeys fed other MOLM diets. Feed cost per kg gain decreased significantly (p < 0.05) with increasing levels of MOLM in the diets. The PCV, Hb, WBC, MCV, MCH and MCHC values of grower turkeys fed 20% MOLM diet were significantly (p < 0.05) higher than those of grower turkeys fed other diets. It was concluded that a diet containing 20% MOLM is adequate for the normal growth of grower turkeys in the tropics.

Keywords: Diets, grower turkeys, Moringa oleifera leaf meal, response, tropical environment

Procedia PDF Downloads 144
596 An End-to-end Piping and Instrumentation Diagram Information Recognition System

Authors: Taekyong Lee, Joon-Young Kim, Jae-Min Cha

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Piping and instrumentation diagram (P&ID) is an essential design drawing describing the interconnection of process equipment and the instrumentation installed to control the process. P&IDs are modified and managed throughout a whole life cycle of a process plant. For the ease of data transfer, P&IDs are generally handed over from a design company to an engineering company as portable document format (PDF) which is hard to be modified. Therefore, engineering companies have to deploy a great deal of time and human resources only for manually converting P&ID images into a computer aided design (CAD) file format. To reduce the inefficiency of the P&ID conversion, various symbols and texts in P&ID images should be automatically recognized. However, recognizing information in P&ID images is not an easy task. A P&ID image usually contains hundreds of symbol and text objects. Most objects are pretty small compared to the size of a whole image and are densely packed together. Traditional recognition methods based on geometrical features are not capable enough to recognize every elements of a P&ID image. To overcome these difficulties, state-of-the-art deep learning models, RetinaNet and connectionist text proposal network (CTPN) were used to build a system for recognizing symbols and texts in a P&ID image. Using the RetinaNet and the CTPN model carefully modified and tuned for P&ID image dataset, the developed system recognizes texts, equipment symbols, piping symbols and instrumentation symbols from an input P&ID image and save the recognition results as the pre-defined extensible markup language format. In the test using a commercial P&ID image, the P&ID information recognition system correctly recognized 97% of the symbols and 81.4% of the texts.

Keywords: object recognition system, P&ID, symbol recognition, text recognition

Procedia PDF Downloads 153
595 Continuity of Place-Identity: Identifying Regional Components of Kerala Architecture through 1805-1950

Authors: Manoj K. Kumar, Deepthi Bathala

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Man has the need to know and feel as a part of the historical continuum and it is this continuum that reinforces his identity. Architecture and the built environment contribute to this identity as established by the various identity theories exploring the relationship between the two. Architecture which is organic has been successful in maintaining a continuum of identity until the advent of globalization when the world saw a drastic shift to architecture of ‘placelessness’. The answer to the perfect synthesis of ‘universalization’ and ‘regionalism’ is an ongoing quest. However, history has established a smooth transition from vernacular to colonial to modern unlike the architecture of today. The traditional Kerala architecture has evolved from the tropical climate, geography, local needs, materials, skills and foreign influences. It is unique in contrast to the architecture of the neighboring states as a result of the geographical barriers however influenced by the architecture of the Orient due to trade relations. Through 1805 to 1950, the European influence on the architecture of Kerala resulted in the emergence of the colonial style which managed to establish a continuum of the traditional architecture. The paper focuses on the identification of the components of architecture that established the continuity of place-identity in the architecture of Kerala and examines the transition from the traditional Kerala architecture to colonial architecture during the colonial period. Visual surveys based on the principles of urban design, cognitive mapping, typology analysis followed by the strong understanding of the morphological and built environment along with the matrix method are the research tools used. The understanding of these components of continuity can be useful in creating buildings which people can relate to in the present day. South-Asia shares the history of colonialism and the understanding of these components can pave the way for further research on how to establish a regional identity in the era of globalization.

Keywords: colonial, identity, place, regional

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594 Community Education Leadership and Organizational Culture: Perceptions of Empowerment

Authors: Aisha M. Khairat

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Community education in the Arab Republic of Egypt is a model that provides education to remote, underprivileged villages and hamlets where children have no access to public education. The community education model is based on the philosophy of transforming individuals to reach their full potential and on instilling the seeds of empowerment and citizenship to induce societal transformation. This research aims at investigating the degree to which the leadership style and organizational culture of the Egyptian community schools demonstrates an empowering approach. Nile Valley NGO, an Egyptian Non-Governmental Organization (NGO) leading hundreds of Egyptian community schools was studied to investigate the perceptions of empowerment amongst its leadership. This in turn will have serious implications on the level of empowerment the communities managed by Nile Valley NGO are experiencing, and will serve as an indicator to the degree to which community schools are achieving their goals in transforming individuals and empowering communities and reforming Egyptian education – and not just a tool to reach literacy. This mixed-methods research utilized surveys and semi-structured interviews to capture the perceptions of empowerment in the views of a sample of 380 community schools facilitators (teachers) spanning 8 Egyptian governorates and Nile Valley NGO’s community education project team and leadership. The findings demonstrate interesting leadership approaches with traits from transformational and servant leadership theoretical models. The organizational culture at Nile Valley NGO reflects the universal dichotomy between market-oriented and humanitarian orientations. The perceptions of empowerment were positive, and several success stories were uncovered in spite of the many challenges faced on the national level and despite the scarcity or resources.

Keywords: community education, community schools in Egypt, empowerment, organizational culture, leadership

Procedia PDF Downloads 179
593 Clinical Profile and Outcome of Type I Diabetes Mellitus at a Tertiary Care-Centre in Eastern Nepal

Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

Procedia PDF Downloads 254