Search results for: the effectiveness of trauma treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11983

Search results for: the effectiveness of trauma treatment

11113 Effectiveness of Micro-Credit Scheme of Community Women and Development (COWAD) in Enhancing Living Standards of Women in Oyo State, Nigeria

Authors: Olufunmilayo Folaranmi

Abstract:

The study aimed at assessing the effectiveness of micro-credit scheme of (COWAD) in enhancing the living standard of women in selected local government areas of Oyo State. A survey research design was adopted for the study. A sample of 250 respondents was purposively selected for the study while a structured questionnaire tagged Effectiveness of Micro-Credit Scheme of Community Women and Development and Living Standards of Women Questionnaire (EMCSCWDQ) was designed to collect data for the study. Data collected was analyzed using frequency distribution, tables, percentages and chi-square statistics. Three hypotheses were tested for the study at 0.05 level of significance. Findings from the study indicated that loan provided by COWAD for women in selected local government areas towards improving their economic conditions has improved the living conditions of the women, promoted their general welfare, and reduced their poverty level. Findings also showed that some beneficiaries were not able to pay back, therefore reducing the effectiveness for future beneficiaries. Based on the findings, it was recommended that the providers of various micro-credit schemes of the state should design a convenient pattern of payment which will provide enough time for the beneficiaries of the loan to sell their goods or work for proper and timely payment. Also, the problem of collateral should be reviewed as the majority of women involved are poor. Other recommendations include replication of COWAD facilities in other NGOs as well as sustainability of the facility.

Keywords: micro-credit scheme, welfare, women, development, poverty

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11112 Anti-Inflammatory Effect of Carvedilol 1% Ointment in Topical Application to the Animal Model

Authors: Berina Pilipović, Saša Pilipović, Maja Pašić-Kulenović

Abstract:

Inflammation is the body's response to impaired homeostasis caused by infection, injury or trauma resulting in systemic and local effects. Inflammation causes the body's response to injury and is characterized by a series of events including inflammatory response, response to pain receptors and the recovery process. Inflammation can be acute and chronic. The inflammatory response is described in three different phases. Free radical is an atom or molecule that has the unpaired electron and is therefore generally very reactive chemical species. Biologically important example of reaction with free radicals is called Lipid peroxidation (LP). Lipid peroxidation reactions occur in biological membranes, and if at the outset is not stopped with the action of antioxidants, it will bring damage to the membrane, which results in partial or complete loss of their physiological functions. Calcium antagonists and beta-adrenergic receptor antagonists are known drugs, and for many years and widely used in the treatment of cardiovascular diseases. Some of these compounds also show antioxidant activity. The mechanism of antioxidant activities of calcium antagonists and beta-blockers is unknown, since their structure varies widely. This research investigated the possible local anti-inflammatory activity of ointments containing 1% carvedilol in the white petrolatum USP. Ear inflammation was induced by 3% croton oil acetone solution, in quantity of 10 µl on both mouse ears. Albino Swiss mouse (n = 8) are treated with 2.5 mg/ear ointment, and control group was treated on the same way as previous with hydrocortisone 1% ointment (2.5 mg/ear). The other ear of the same animal was used as control one. Ointments were administered once per day, on the left ear. After treatment, ears were observed for three days. After three days, we measured mass (mg) of 6 mm ear punch of treated and controlled ears. The results of testing anti-inflammatory effects of ointments with carvedilol in the mouse ear model show stronger observed effect than ointment with 1% hydrocortisone in the same basis. Identical results were confirmed by the difference between the mass of 6 mm ears punch. The results were also confirmed by histological examination. Ointments with carvedilol showed significant reduction of the inflammation process caused by croton oil on the mouse inflammation model.

Keywords: antioxidant, carvedilol, inflammation, mouse ear

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11111 Botulinum Toxin a in the Treatment of Late Facial Nerve Palsy Complications

Authors: Akulov M. A., Orlova O. R., Zaharov V. O., Tomskij A. A.

Abstract:

Introduction: One of the common postoperative complications of posterior cranial fossa (PCF) and cerebello-pontine angle tumor treatment is a facial nerve palsy, which leads to multiple and resistant to treatment impairments of mimic muscles structure and functions. After 4-6 months after facial nerve palsy with insufficient therapeutic intervention patients develop a postparalythic syndrome, which includes such symptoms as mimic muscle insufficiency, mimic muscle contractures, synkinesis and spontaneous muscular twitching. A novel method of treatment is the use of a recent local neuromuscular blocking agent– botulinum toxin A (BTA). Experience of BTA treatment enables an assumption that it can be successfully used in late facial nerve palsy complications to significantly increase quality of life of patients. Study aim. To evaluate the efficacy of botulinum toxin A (BTA) (Xeomin) treatment in patients with late facial nerve palsy complications. Patients and Methods: 31 patients aged 27-59 years 6 months after facial nerve palsy development were evaluated. All patients received conventional treatment, including massage, movement therapy etc. Facial nerve palsy developed after acoustic nerve tumor resection in 23 (74,2%) patients, petroclival meningioma resection – in 8 (25,8%) patients. The first group included 17 (54,8%) patients, receiving BT-therapy; the second group – 14 (45,2%) patients continuing conventional treatment. BT-injections were performed in synkinesis or contracture points 1-2 U on injured site and 2-4 U on healthy side (for symmetry). Facial nerve function was evaluated on 2 and 4 months of therapy according to House-Brackman scale. Pain syndrome alleviation was assessed on VAS. Results: At baseline all patients in the first and second groups demonstrated аpostparalytic syndrome. We observed a significant improvement in patients receiving BTA after only one month of treatment. Mean VAS score at baseline was 80,4±18,7 and 77,9±18,2 in the first and second group, respectively. In the first group after one month of treatment we observed a significant decrease of pain syndrome – mean VAS score was 44,7±10,2 (р<0,01), whereas in the second group VAS score was as high as 61,8±9,4 points (p>0,05). By the 3d month of treatment pain syndrome intensity continued to decrease in both groups, but, the first group demonstrated significantly better results; mean score was 8,2±3,1 and 31,8±4,6 in the first and second group, respectively (р<0,01). Total House-Brackman score at baseline was 3,67±0,16 in the first group and 3,74±0,19 in the second group. Treatment resulted in a significant symptom improvement in the first group, with no improvement in the second group. After 4 months of treatment House-Brockman score in the first group was 3,1-fold lower, than in the second group (р<0,05). Conclusion: Botulinum toxin injections decrease postparalytic syndrome symptoms in patients with facial nerve palsy.

Keywords: botulinum toxin, facial nerve palsy, postparalytic syndrome, synkinesis

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11110 [Keynote Speech]: An Overview on the Effectiveness of Critical Thinking on Knowledge

Authors: Solehah Yaacob

Abstract:

The study focuses on revisiting the effectiveness of Critical Thinking in human mind capability as a major faculty in human life. The tool used as a measurement of this knowledge ability consists of several processes including experience and education background. To emphasize the `Overview` concept, the researcher highlights two major aspects of philosophical approach, they are; Divine Revelation Concept and Modern Scientific Theory. The research compares between the both parties to introduce the Divine Revelation into Modern Scientific theory. An analytical and critical study of the both concepts become the methodology of the discussion.

Keywords: critical thinking, knowledge, intellectual, language

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11109 External Vacuum Dressing: Optimising Non-Operative Management of Flail Sternum Post CPR

Authors: Nicholas Bayfield, Mark Newman

Abstract:

Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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11108 Preliminary Study on Using of Thermal Energy from Effluent Water for the SBR Process of RO

Authors: Gyeong-Sung Kim, In-soo Ahn, Yong Cho

Abstract:

SBR (Sequencing Batch Reactor) process is usually applied to membrane water treatment plants to treat its concentrated wastewater. The role of SBR process is to remove COD (Chemical Oxygen Demand) and NH3 from wastewater before discharging it outside of the water treatment plant using microorganism. Microorganism’s nitrification capability is influenced by water temperature because the nitrification rate of the concentrated wastewater becomes ‘zero’ as water temperature approach 0℃. Heating system is necessary to operate SBR in winter season even though the operating cost increase sharply. The operating cost of SBR at ‘D’ RO water treatment plant in Korea was 51.8 times higher in winter (October to March) compare to summer (April to September) season in 2014. Otherwise the effluent water temperature maintained around 8℃ constantly in winter. This study focuses on application heat pump system to recover the thermal energy from the effluent water of ‘D’ RO plant so that the operating cost will be reduced.

Keywords: water treatment, water thermal energy, energy saving, RO, SBR

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11107 Treatment of Psoriasis through Thai Traditional Medicine

Authors: Boonsri Lertviriyachit

Abstract:

The objective of this research is to investigate the treatment of psoriasis through Thai traditional medicine in the selected areas of 2 east coast provinces; Samudprakarn Province and Chantaburi Province. The informants in this study were two famous and accepted Thai traditional doctors, who have more than 20 year experiences. Data were collected by in depth interviews and participant-observation method. The research instrument included unstructured interviews, camera, and cassette tape to collect data analyzed by descriptive statistics. The results revealed that the 2 Thai traditional doctors were 54 and 85 years old with 25 and 45 years of treatment experiences. The knowledge of Thai traditional medicine was transferred from generations to generations in the family. The learning process was through close observation as an apprentice with the experience ones and assisted them in collecting herbs and learning by handling real case in individual situations. Before being doctors, they had to take exam to get the Thai traditional medical certificate. Knowledge of being Thai traditional doctors included diagnosis and find to the suitable way of treatment. They have to look into disorder physical fundamental factors such as blood circulation, lymph, emotion, and food consumption habit. It is important that the treatment needs to focus on balancing the fundamental factors and to observe contraindication.

Keywords: Thai traditional medicine, psoriasis, Samudprakarn Province, Chantaburi Province

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11106 Observational Study of Ionising Radiation Exposure in Orthopaedic Theatre

Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

Abstract:

Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

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11105 Sewage Sludge Management: A Case Study of Monrovia, Montserrado County, Liberia

Authors: Victor Emery David Jr, Md S. Hossain

Abstract:

Sewage sludge management has been a problem faced by most developing cities as in the case of Monrovia. The management of sewage sludge in Monrovia is still in its infant stage. The city is still struggling with poor sanitation, clogged pipes, shortage of septic tanks, lack of resources/human capacity, inadequate treatment facilities, open defecation, the absence of clear guidelines, etc. The rapid urban population growth of Monrovia has severely stressed Monrovia’s marginally functional urban WSS system caused by the civil conflict which led to break down in many sectors as well as infrastructure. The sewerage system which originally covered 17% of the population of Monrovia was down to serving about 7% because of bursts and blockages causing backflows in other areas. Prior to the Civil War, the average water production for Monrovia was about 68,000 m3/day but has now dropped to about 10,000 m3/day. Only small parts of Monrovia currently have direct access to the piped water supply while most areas depend on trucked water delivered to community collection points or household tanks, and/or on water from unprotected dug wells or hand pumps. There are only two functional treatment plants; The Fiamah Treatment plant and the White Plains Treatment Plant.

Keywords: Fiamah Treatment plant, management, Monrovia/Montserrado County, sewage, sludge

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11104 The Effects of Therapy on Oxidative Stress, Ghrelin and Nesfatin-1 Levels in Iron Deficiency Anemia

Authors: Emrah Caylak

Abstract:

The aim of this study is to investigate the effect of iron therapy on oxidative stress, ghrelin, and nesfatin-1 levels in patients with iron deficiency anemia (IDA). Thirty patients who applied to Internal Medicine Clinic and were diagnosed with IDA and also 30 healthy individuals as a control were included in the study. The samples were collected from IDA patients before and after treatment. Differences in serum MDA, TAC, and plasma ghrelin, nesfatin-1 were analyzed among the three groups. Serum MDA and TAC levels were found higher and lower in IDA patients before the treatment group compared to the controls (p < 0.05). After the iron therapy, plasma acylated ghrelin and nesfatin-1 levels in IDA patients were found higher in IDA patients before the treatment group and controls (p < 0.05). Plasma ghrelin and nesfatin-1 levels increase with iron treatment in IDA patients. The iron therapy induces the synthesis of ghrelin and nesfatin-1 in human body, thus causes increased appetite and food intake.

Keywords: anemia, oxidative stress, ghrelin, nesfatin-1

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11103 Effectiveness of Metacognitive Therapy in Metacognitive Beliefs, Anxiety and Social Phobia of Male High School Students

Authors: Saba Hasanvandi, Molok Khademi Ashkezari, Niloofar Esmaieli

Abstract:

The research purpose was to assess the effectiveness of metacognitive therapy in metacognitive beliefs, anxiety and social phobia of male students studying in the high schools of Dargaz City. The sample comprised 30 students who were randomly selected and assigned to the experimental and control groups. The kind of this study was experimental study with pre-ops and follow-up stages. Subjects filled out metacognitive beliefs, anxiety and social phobia questionnaires. The experimental group underwent 10 sessions of therapeutic metacognitive sessions. The group therapy was conducted for ten, weekly, 90-minute sessions. Mankova analysis was utilized to analyze the data. Results revealed that metacognitive group therapy decreased metacognitive beliefs (P=0.007), anxiety (P<0.001) and social phobia (P=<0.017) in the experimental group as compared to the control group. Furthermore, the effectiveness of group metacognitive therapy was stable and consistent after one month of time interval. The results of present study can be effective for mental health professional in reaching a better understanding of anxiety and social phobia.

Keywords: group metacognitive therapy, metacognitive beliefs, anxiety, social phobia, high school students

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11102 Bio-Electrochemical Process Coupled with MnO2 Nanowires for Wastewater Treatment

Authors: A. Giwa, S. M. Jung, W. Fang, J. Kong, S. W. Hasan

Abstract:

MnO2 nanowires were developed as filtration media for wastewater treatment that uniquely combines several advantages. The resulting material demonstrated strong capability to remove the pollution of heavy metal ions and organic contents in water. In addition, the manufacture process of such material is practical and economical. In this work, MnO2 nanowires were integrated with the state-of-art bio-electrochemical system for wastewater treatment, to overcome problems currently encountered with organic, inorganic, heavy metal, and microbe removal, and to minimize the unit footprint (land/space occupation) at low cost. Results showed that coupling the bio-electrochemical with MnO2 resulted in very encouraging results with higher removal efficiencies of such pollutants.

Keywords: bio-electrochemical, nanowires, novel, wastewater

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11101 Bacterio-Algal Microbial Fuel Cells for Sustainable Power Production, Wastewater Treatment, and Desalination

Authors: Ann D. Christy, Beenish Saba

Abstract:

The Microbial fuel Cell (MFC) is a successful integrated technology for power production and wastewater treatment. MFCs are recognized for their dual function, but research in this field is still ongoing to increase efficiency and power output. One such effort is successful integration of phototrophic and autotrophic microorganisms to create bacterio-algal MFCs for sustainable electricity production along with wastewater treatment and algal biomass production. An MFC is typically configured with an anaerobic anodic chamber containing exoelectrogenic microorganisms separated by a cation exchange membrane from an adjacent aerobic cathodic chamber. The two electrodes are connected by an external circuit. This conventional MFC can be converted into a phototrophic MFC by introducing photosynthetic microorganisms into the cathode chamber. This study examines adding a third desalination chamber to a two-chamber bacterio-algal MFC. Successful results have been observed from these three-chamber MFCs demonstrating wastewater treatment in the anodic chamber, phototrophic algal growth in the cathodic chamber, and desalination in the middle chamber. The present article will summarize successful results of the bacterio-algal fuel cells and offer insights about the mechanisms involved. Tables summarizing the input substrate along with optimized operational conditions and output performance in terms of power production and efficiencies of water and wastewater treatment will be presented. The negative impacts and challenges will be discussed, along with possible future research directions. Results suggest that the three chamber bacterio-algal desalination cell has potential as a feasible technology for power production, wastewater treatment and desalination, but it needs further investigation under optimized conditions.

Keywords: bacterio-algal MFC, three chamber, microbial fuel cell, wastewater treatment and desalination

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11100 Biodegradable and Bioactive Scaffold for Bone Tissue Engineering

Authors: A. M. Malagon Escandon, J. A. Arenas Alatorre, C. P. Chaires Rosas, N. A. Vazquez Torres, B. Hernandez Tellez, G. Pinon Zarate, M. Herrera Enriquez, A. E. Castell Rodriguez

Abstract:

The current approach to the treatment of bone defects involves the use of scaffolds that provide a biological and mechanically stable niche to favor tissue repair. Despite the significant progress in the field of bone tissue engineering, several main problems associated are attributed to giving a low biodegradation degree, does not promote osseointegration and regeneration, if the bone is not healing as well as expected or fails to heal, will not be given a proper ossification or new bone formation. The actual approaches of bone tissue regeneration are directed to the use of decellularized native extracellular matrices, which are able of retain their own architecture, mechanic properties, biodegradability and promote new bone formation because they are capable of conserving proteins and other factors that are founded in physiological concentrations. Therefore, we propose an extracellular matrix-based bioscaffolds derived from bovine cancellous bone, which is processed by decellularization, demineralization, and hydrolysis of the collagen protein, these protocols have been successfully carried out in other organs and tissues; the effectiveness of its biosafety has also been previously evaluated in vivo and Food and Drug Administration (FDA) approved. In the specific case of bone, a more complex treatment is needed in comparison with other organs and tissues because is necessary demineralization and collagen denaturalization. The present work was made in order to obtain a temporal scaffold that succeed in degradation in an inversely proportional way to the synthesis of extracellular matrix and the maturation of the bone by the cells of the host.

Keywords: bioactive, biodegradable, bone, extracellular matrix-based bioscaffolds, stem cells, tissue engineering

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11099 Lateral Sural Artery Perforators: A Cadaveric Dissection Study to Assess Perforator Surface Anatomy Variability and Average Pedicle Length for Flap Reconstruction

Authors: L. Sun, O. Bloom, K. Anderson

Abstract:

The medial and lateral sural artery perforator flaps (MSAP and LSAP, respectively) are two recently described flaps that are less commonly used in lower limb trauma reconstructive surgeries compared to flaps such as the anterolateral thigh (ALT) flap or the gastrocnemius flap. The LSAP flap has several theoretical benefits over the MSAP, including the ability to be sensate and being more easily manoeuvred into position as a local flap for coverage of lateral knee or leg defects. It is less commonly used in part due to a lack of documented studies of the anatomical reliability of the perforator, and an unquantified average length of the pedicle used for microsurgical anastomosis (if used as a free flap) or flap rotation (if used as a pedicled flap). It has been shown to have significantly lower donor site morbidity compared to other flaps such as the ALT, due to the decreased need for intramuscular dissection and resulting in less muscle loss at the donor site. 11 cadaveric lower limbs were dissected, with a mean of 1.6 perforators per leg, with an average pedicle length of 45mm to the sural artery and 70mm to the popliteal artery. While the majority of perforating arteries lay close to the midline (average of 19mm lateral to the midline), there were patients whose artery was significantly lateral and would have been likely injured by the initial incision during an operation. Adding to the literature base of documented LSAP dissections provides a greater understanding of the anatomical basis of these perforator flaps, and the authors hope this will establish them as a more commonly used and discussed option when managing complicated lower limb trauma requiring soft tissue reconstruction.

Keywords: cadaveric, dissection, lateral, perforator flap, sural artery, surface anatomy

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11098 Growing Evaluation Process in Chamaedorea Linearis with Humus from Biosolids of the Wastewater Treatment Plant, Nueva Granada Military University Cajica

Authors: J. Gonzalez, P. Jimenez, C. Isaza

Abstract:

Palms have different characteristics that make them vulnerable; that is the case of the Chamaedorea linearis, with the presence of solitary stems of small diameter and medium leaves, culturally harvested, and in religious festivities used. Additionally, they present a weak apical meristem as the only emergency point, slow development and growth, and an affectation due to the high rate of deforestation in Colombia. Propagation of this species can improve the pressure on wild populations and help their survival in the environment. In this study was used in 177 plants biosolids humus from the Wastewater Treatment Plant (WWTP), located at the UMNG Campus Cajica (Cundinamarca, Colombia). The experiment used a control and two treatments with 10% and 20% of humus. During the process, the variables evaluated were number of leaves, percentage of chlorophyll, stem length, and estimated leaf area. The data set were taking during 14 weeks before the reproductive maturity, evidencing that the most representative development of the palms was in the treatment of 20%, plants in this treatment presented major number of leaves, larger stems, a high quantity of chlorophyll, and was a first treatment that present pinnate leaves them represent an important point in maturity process. The research gives an opportunity to improve times of growth in another species of palms and plants (Product result from INV ING 2986 UMNG).

Keywords: biosolids, humus, growth, palms, wastewater treatment plant, WWTP

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11097 Economic Cost of Malaria: A Threat to Household Income in Nigeria

Authors: Nsikan Affiah, Kayode Osungbade, Williams Uzoma

Abstract:

Malaria remains one of the major killers of humans worldwide, threatening the lives of more than one-third of the world’s population. Some people refers it to; a disease of poverty because it contributes towards national poverty through its impact on foreign direct investment, tourism, labour productivity, and trade. At the micro level, it may cause poverty through spending on health care, income losses, and premature deaths. Unfortunately, malaria is a disease that affects both low-income household and its high-income counterpart, but low-income households are still at greater risk because significant part of the available monthly income is dedicated to various preventive and treatment measures. The objective of this study is to estimate direct and indirect cost of malaria treatment in households in a section of South-South Region (Akwa Ibom State) of Nigeria. A cross-sectional study of Six Hundred and Forty (640) heads of households or any adult representative of households in three local government areas of Akwa Ibom State, Nigeria from May 1-31, 2015 were ascertained through interviewer-administered questionnaire adapted from Nigerian Malaria Indicator Survey Report. The clustering technique was used to select 640 households with the help of Primary Health Care (PHC) house numbering system. Using exchange rate of 197 Naira/USD, result shows that direct cost of malaria treatment was 8,894.44 USD while the indirect cost of malaria treatment was 11,012.81 USD. Total cost of treatment made up of 44.7% direct cost and 55.3% indirect cost, with average direct cost of malaria treatment per household estimated at 20.6 USD and the average indirect cost of treatment per household estimated at 25.1 USD. Average total cost for each episode (888) of malaria was estimated at 22.4 USD. While at household level, the average total cost was estimated at 45.5 USD. From the average total cost, low-income households would spend 36% of monthly household income on treating malaria and the impact could be said to be catastrophic, compared to high-income households where only 1.2% of monthly household income is spent on malaria treatment. It could be concluded that the cost of malaria treatment is well beyond the means of households and given the reality of repeated bouts of malaria and its contribution to the impoverishment of households, there is a need for urgent action.

Keywords: direct cost, indirect cost, low income households, malaria

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11096 Agronomic Value of Wastewater and Sugar Beet Lime Sludge Compost on Radish Crop

Authors: S. Rida, O. Saadani Hassani, Q. R’zina, N. Saadaoui, K. Fares

Abstract:

Wastewater treatment stations create large quantities of sludge, whose treatment is poorly underestimated in the draft installation. However, chemical analysis of sludge reveals their important concentration in fertilizer elements including nitrogen and phosphorus. The direct application of sludge can reveal contamination of the food chain because of their chemical and organic micropollutants load. Therefore, there is a need of treatment process before use. The treatment by composting of this sludge mixed with three different proportions of sugar beet lime sludge (0%, 20%,30%) and green waste permits to obtain a stable compost rich in mineral elements, having a pleasant smell and relatively hygienic. In addition, the use of compost in agriculture positively affects the plant-soil system. Thus, this study shows that the supply of compost improves the physical properties of the soil and its agronomic quality, which results in an increase in the biomass of cultivated radish plants and a larger crop.

Keywords: agriculture, composting, soil, sugar beet lime, wastewater

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11095 Biocompatible Hydrogel Materials Containing Cytostatics for Cancer Treatment

Authors: S. Kudlacik-Kramarczyk, M. Kedzierska, B. Tyliszczak

Abstract:

Recently, the continuous development of medicine and related sciences has been observed. Particular emphasis is directed on the development of biomaterials, i.e., non-toxic, biocompatible and biodegradable materials that may improve the effectiveness of treatment as well as the comfort of patients. This is particularly important in the case of cancer treatment. Currently, there are many methods of cancer treatment based primarily on chemotherapy and the surgical removal of the tumor, but it is worth noting that these therapies also cause many side effects. Among women, the most common cancer is breast cancer. It may be completely cured, but the consequence of treatment is partial or complete breast mastectomy and radiation therapy, which results in severe skin burns. The skin of the patient after radiation therapy is very burned, and therefore requires intensive care and high frequency of dressing changes. The traditional dressing adheres to the burn wounds and does not absorb adequate amount of exudate from injuries and the patient is forced to change the dressing every 2 hours. Therefore, the main purpose was to develop an innovative combination of dressing material with drug carriers that may be used in anti-cancer therapy. The innovation of this solution is the combination of these two products into one system, i.e., a transdermal system with the possibility of a controlled release of the drug- cytostatic. Besides, the possibility of modifying the hydrogel matrix with aloe vera juice provides this material with new features favorable from the point of view of healing processes of burn wounds resulting from the radiation therapy. In this study, hydrogel materials containing protein spheres with the active substance have been obtained as a result of photopolymerization process. The reaction mixture consisting of the protein (albumin) spheres incorporated with cytostatic, chitosan, adequate crosslinking agent and photoinitiator has been subjected to the UV radiation for 2 minutes. Prepared materials have been subjected to the numerous studies including the analysis of cytotoxicity using murine fibroblasts L929. Analysis was conducted based on the mitochondrial activity test (MTT reduction assay) which involves the determining the number of cells characterized by proper metabolism. Hydrogel materials obtained using different amount of crosslinking agents have been subjected to the cytotoxicity analysis. According to the standards, tested material is defined as cytotoxic when the viability of cells after 24 h incubation with this material is lower than 70%. In the research, hydrogel polymer materials containing protein spheres incorporated with the active substance, i.e. a cytostatic, have been developed. Such a dressing may support the treatment of cancer due to the content of the anti-cancer drug - cytostatic, and may also provide a soothing effect on the healing of the burn wounds resulted from the radiation therapy due to the content of aloe vera juice in the hydrogel matrix. Based on the conducted cytotoxicity studies, it may be concluded that the obtained materials do not adversely affect the tested cell lines, therefore they can be subjected to more advanced analyzes.

Keywords: hydrogel polymers, cytostatics, drug carriers, cytotoxicity

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11094 Strategic Decision Making Practice in Croatia: Which Decision Making Style is More Effective?

Authors: Ivana Bulog

Abstract:

Decision making is a vital part of the business world and any other field of human endeavor. Which way a business organization will take, and where that way will lead it, depends on broad range of decisions made by managers in the managerial structure. Strategic decisions are of the greatest importance for organizational success. Although much empirical research has been done trying to describe and explain its nature and effectiveness, knowledge about strategic decision making is still incomplete. This paper explores the nature of strategic decision making in particular setting - in Croatian companies. The main focus of this research is on the style that decision makers on strategic management level are following when making decisions of life importance for their companies. Two main decision making style that explain the way decision maker collects and processes available information and performs all the activities in strategic decision making process were empirical tested: rational and intuitive one. Besides analyzing their existence on strategic management level in Croatian companies, their effectiveness is analyzed as well. Results showed that decision makers at strategic management level are following both styles somewhat equally in order to function effectively, and that intuitive style is more effective when considering decisions outcomes.

Keywords: decision making style, decision making effectiveness, strategic decisions, management sciences

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11093 Enhance Biogas Production by Enzymatic Pre-Treatment from Palm Oil Mill Effluent (POME)

Authors: M. S. Tajul Islam, Md. Zahangir Alam

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To enhance biogas production through anaerobic digestion, the application of various type of pre-treatment method has some limitations in terms of sustainable environmental management. Many studies on pretreatments especially chemical and physical processes are carried out to evaluate the anaerobic digestion for enhanced biogas production. Among the pretreatment methods acid and alkali pre-treatments gained the highest importance. Previous studies have showed that although acid and alkali pretreatment has significant effect on degradation of biomass, these methods have some negative impact on environment due to their hazard in nature while enzymatic pre-treatment is environmentally friendly. One of the constrains to use of enzyme in pretreatment process for biogas production is high cost which is currently focused to reduce cost through fermentation of waste-based media. As such palm oil mill effluent (POME) as an abundant resource generated during palm oil processing at mill is being used a potential fermentation media for enzyme production. This low cost of enzyme could be an alternative to biogas pretreatment process. This review is to focus direct application of enzyme as enzymatic pre-treatment on POME to enhanced production of biogas.

Keywords: POME, enzymatic pre-treatment, biogas, lignocellulosic biomass, anaerobic digestion

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11092 The Major Challenge of the Health System Health Management Services in Kosovo and Impact on Satisfaction

Authors: Nevruz Zogu, Shpetim Rezniqi

Abstract:

In the framework of transformational economic development social pluralism and the free, market health systems operating in the countries of our region are naturally involved in a process of profound change and reform. Health systems actually represent complex ensembles centers and public and private institutions (domestic and foreign), who administer substantial amounts of human, technological, material, financial, information and scientific facts • The goal of health systems is much more than medical care. It includes the promotion, protection, treatment and rehabilitation of health of the population. • Meeting the needs of increasingly diverse broader health services efficient, secure the quality and affordability of their increasing cost of unstoppable, requires the necessary reform of health systems and implementing policies and new management methods, to ensure effectiveness and health benefits as higher population.

Keywords: health, management, economy, finance

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11091 Survival Outcomes Related to Treatment Modalities in Patients with Oropharyngeal Squamous Cell Carcinoma

Authors: Danni Cheng

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Purpose:Surgicallyinclusive treatment(SIT)isthemajor treatment fororopharyngealsquamouscellcarcinoma (OPSCC) in Eastern countries, while nonsurgical treatments(NSTs) are the priority treatment in Western countries. The preferred treatmentsforOPSCC patients remaindebated. Methods:Atotalof 153 consecutive OPSCC casesdiagnosed between 2009 and 2019inWCH, and 15,400 OPSCC cases from SEER database (2000-2017) were obtained. Clinical characteristics, treatments, and survival outcomes were retrospectively collected. We conductedKaplan-Meier curves univariate and multivariate analysis to compare the prognosis of OPSCC patients in WCH, SEER Asian, and SEER all ethnic population by different treatment modalities,HPVstatus, ages, and TNM stages. Results: The 5-year overall survival rate was 59% in WCH, 64% in the SEER all ethnic and 67% in SEER Asian group. In both univariate and multivariate analysis, SIT was observed as a consistent benefit factor for OPSCC patients in all three populations when classified by genders, tumor stages, and HPV status. Patients who underwent SIT had significantly better survival outcomes than those who received NSTsin WCH, SEER Asian, and SEER all ethnic groups. HPV positive status was the beneficial factor of OPSCC patients in all three groups. Besides, male patients had worse survival outcomes in both WCH and SEER Asian group, whereas male patients had better outcomes in the SEER all ethnic group. Conclusion: In contrast to nowadaysNSTs are the first-line therapiesfor OPSCC, our ten-year real-world data and SEER data indicated that OPSCC patients who underwent SIT had better prognosis than NSTs.

Keywords: OPSCC, survival outcome, SEER, treatment modalities

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11090 Preparation and Fabrication of Lithium Disilicate Glass Ceramic as Dental Crowns via Hot Pressing Method

Authors: A. Srion, W. Thepsuwan, N. Monmaturapoj

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Two Lithium disilicate (LD) glass ceramics based on SiO2-Li2O-K2O-Al2O3 system were prepared through glass melting method and then fabricated into dental crowns via hot pressing at 850˚C and 900˚C in order to study the effect of the pressing temperatures on theirs phase formation and microstructure. The factor such as heat treatment temperature (as-cast glass, 600˚C and 700˚C) of the glass ceramics used to press was also investigated the effect of an initial microstructure before pressing. X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used to determine phase formation and microstructure of the samples, respectively. X-ray diffraction result shows that the main crystalline structure was Li2Si2O5 by having Li3PO4, Li0.6Al0.6Si2O6, Li2SiO3, Ca5 (PO4)3F, SiO2 as minor phases. Glass compositions with different heat treatment temperatures exhibited a difference phase formation but have less effect during pressing. Scanning electron microscopy analysis showed microstructure of lath-like of Li2Si2O5 in all glasses. With increasing the initial heat treatment temperature, the longer the lath-like crystals of lithium disilicate were increased especially when using glass heat treatment at 700˚C followed by pressing at 900˚C. This could be suggested that LD1 heat treatment at 700˚C which pressing at 900˚C presented the best formation by hot pressing and compiled microstructure.

Keywords: lithium disilicate, hot pressing, dental crown, microstructure

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11089 The Impact of Artesunate-Amodiaquine on Schistosoma mansoni Infection among Children Infected by Plasmodium in Rural Area of Lemfu, Kongo Central, Democratic Republic of the Congo

Authors: Mbanzulu Kennedy, Zanga Josue, Wumba Roger

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Malaria and schistosomiasis remain life-threatening public health problems in sub-Saharan Africa. The infection pattern related to age indicates that preschool and school-age children are at the highest risk of malaria and schistosomiasis. Both parasitic infections, separately or combined, may have negative impacts on the haemoglobin concentration levels. The existing data revealed that artemisinin derivatives commonly used to cure malaria present also in antischistosomal activities. The current study investigated the impact of Artesunate-Amodiaquine (AS-AQ) on schistosomiasis when administered to treat malaria in rural area of Lemfu, DRC. A prospective longitudinal study including 171 coinfected children screened for anaemia, Schistosoma mansoni, and Plasmodium falciparum infections. The egg reduction rate and haemoglobin concentration were assessed four weeks after the treatment with AS-AQ, of all coinfected children of this series. One hundred and twenty-five (74.4%) out of 168 coinfected children treated and present during the assessment were found stool negative for S. mansoni eggs. Out of 43 (25.6%) children who remained positives, 37 (22%) showed a partial reduction of eggs amount, and no reduction was noted in 3.6% of coinfected. The mean of haemoglobin concentration and the prevalence of anaemia were, respectively, 10.74±1.5g/dl , 11.2±1.3g/dl, and 64.8%, 51.8%, respectively, before and after treatment, p<0.001. The AS-AQ commonly used against Plasmodium allowed curing S. mansoni in coinfected children and increasing the Hb level. For the future, the randomized and multicentric clinical trials are needed for a better understanding of the effectiveness of AS-AQ against Schistosoma spp. The trial registration number was 3487183.

Keywords: paludisme, schistosomiase, as-aq, enfants lemfu

Procedia PDF Downloads 87
11088 Psoriasis Diagnostic Test Development: Exploratory Study

Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

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The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

Procedia PDF Downloads 100
11087 Understanding the Underutilization of Electroconvulsive Therapy in Children and Adolescents

Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

Procedia PDF Downloads 111
11086 Metformin Protects Cardiac Muscle against the Pro-Apoptotic Effects of Hyperglycaemia, Elevated Fatty Acid and Nicotine

Authors: Christopher R. Triggle, Hong Ding, Khaled Machaca, Gnanapragasam Arunachalam

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The antidiabetic drug, metformin, has been in clinical use for over 50 years and remains the first choice drug for the treatment of type two diabetes. In addition to its effectiveness as an oral anti-hyperglycaemic drug metformin also possesses vasculoprotective effects that are assumed to be secondary to its ability to reduce insulin resistance and control glycated hemoglobin levels; however, recent data from our laboratory indicate that metformin also has direct vasoprotective effects that are mediated, at least in part, via the anti-ageing gene, SIRT1. Diabetes is a major risk factor for the development of cardiovascular disease (CVD) and it is also well established that tobacco use further enhances the risk of CVD; however, it is not known whether treatment with metformin can offset the negative effects of diabetes and tobacco use on cardiac function. The current study was therefore designed to investigate 1: the effects of hyperglycaemia (HG) either alone or in the presence of elevated fatty acids (palmitate) and nicotine on the protein expression levels of the deacetylase sirtuin 1 (the protein product of SIRT1), anti-apoptotic Bcl-2, pro-apoptotic BIM and the pro-apoptotic, tumour suppressor protein, acetylated p53 in cardiomyocytes. 2: the ability of metformin to prevent the detrimental effects of HG, palmitate and nicotine on cardiomyocyte survival. Cell culture protocols were designed using a rat cardiomyocyte cell line, H9c2, either under normal glycaemic (NG) conditions of 5.5mM glucose, or hyperglycaemic conditions (HG) of 25mM glucose with, or without, added palmitate (250μM) or nicotine (1.0mM) for 24h. Immuno-blotting was used to detect the expression of sirtuin 1, Bcl-2, BIM, acetylated (Ac)-p53, p53 with β-actin used as the reference protein. Exposure to HG, palmitate, or nicotine alone significantly reduced expression of sirtuin1, Bcl-2 and raised the expression levels of acetylated p53 and BIM; however, the combination of HG, palmitate and nicotine had a synergistic effect to significantly suppress the expression levels of sirtuin 1 and Bcl-2, but further enhanced the expression of Ac-p53, and BIM. The inclusion of 1000μM, but not 50μM, metformin in the H9c2 cell culture protocol prevented the effects of HG, palmitate and nicotine on the pro-apoptotic pathways. Collectively these data indicate that metformin, in addition to its anti-hyperglycaemic and vasculoprotective properties, also has direct cardioprotective actions that offset the negative effects of hyerglycaemia, elevated free fatty acids and nicotine on cardiac cell survival. These data are of particular significance for the treatment of patients with diabetes who are also smokers as the inclusion of metformin in their therapeutic treatment plan should help reduce cardiac-related morbidity and mortality.

Keywords: apoptosis, cardiac muscle, diabetes, metformin, nicotine

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11085 A Concept of Rational Water Management at Local Utilities: The Use of RO for Water Supply and Wastewater Treatment/Reuse

Authors: N. Matveev, A. Pervov

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Local utilities often face problems of local industrial wastes, storm water disposal due to existing strict regulations. For many local industries, the problem of wastewater treatment and discharge into surface reservoirs can’t be solved through the use of conventional biological treatment techniques. Current discharge standards require very strict removal of a number of impurities such as ammonia, nitrates, phosphate, etc. To reach this level of removal, expensive reagents and sorbents are used. The modern concept of rational water resources management requires the development of new efficient techniques that provide wastewater treatment and reuse. As RO membranes simultaneously reject all dissolved impurities such as BOD, TDS, ammonia, phosphates etc., they become very attractive for the direct treatment of wastewater without biological stage. To treat wastewater, specially designed membrane "open channel" modules are used that do not possess "dead areas" that cause fouling or require pretreatment. A solution to RO concentrate disposal problem is presented that consists of reducing of initial wastewater volume by 100 times. Concentrate is withdrawn from membrane unit as sludge moisture. The efficient use of membrane RO techniques is connected with a salt balance in water system. Thus, to provide high ecological efficiency of developed techniques, all components of water supply and wastewater discharge systems should be accounted for.

Keywords: reverse osmosis, stormwater treatment, open-channel module, wastewater reuse

Procedia PDF Downloads 307
11084 Absorption Capability Examination of Heavy Metals by Spirogyra Alga in Ahvaz Water Treatment Plant

Authors: F. Fakheri Raof, F. Zobeidizadeh

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The present study examined the potential capability of Spirogyra algae remove heavy metals Zn, Pb, Cu, and Cr from the water. For this purpose, the water treatment No. 3 of Ahvaz County in Khuzestan Province of Iran was selected as a case study. From 8 sampling stations, 4 stations were dedicated to the water samples and 4 stations to the algae samples. According to the obtained results, the concentration of the heavy metals Cr, Cu, Pb, and Zn in water samples were within the ranges of 1.98-19.53, 0.67-13.45, 1-23.18, and 2.12-83.04 µg/L. Besides, the concentration of heavy metal Cr, Pb, Cu, and Zn in spirogyra algae samples varied between the ranges 2.30-3.61, 2.06-3.43, 2.29-2.56, and 9.88-10.84 µg/L. The highest amount of metal absorption in spirogyra algae samples was related to the zinc. The obtained results also indicated that the last spirogyra algae sample which was at the inlet of Tank 4 absorbed the lowest concentration of metals. This would be due to the treatment process along the course of ponds resulted in completely pure water at the outlet without the existence of algae on the sides. The paper also provides some useful recommendations on this issue.

Keywords: absorption, Ahvaz, heavy metal, spirogyra algae, water treatment plants

Procedia PDF Downloads 247