Search results for: methadone treatment
7174 Use of Thrombolytics for Acute Myocardial Infarctions in Resource-Limited Settings, Globally: A Systematic Literature Review
Authors: Sara Zelman, Courtney Meyer, Hiren Patel, Lisa Philpotts, Sue Lahey, Thomas Burke
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Background: As the global burden of disease shifts from infectious diseases to noncommunicable diseases, there is growing urgency to provide treatment for time-sensitive illnesses, such as ST-Elevation Myocardial Infarctions (STEMIs). The standard of care for STEMIs in developed countries is Percutaneous Coronary Intervention (PCI). However, this is inaccessible in resource-limited settings. Before the discovery of PCI, Streptokinase (STK) and other thrombolytic drugs were first-line treatments for STEMIs. STK has been recognized as a cost-effective and safe treatment for STEMIs; however, in settings which lack access to PCI, it has not become the established second-line therapy. A systematic literature review was conducted to geographically map the use of STK for STEMIs in resource-limited settings. Methods: Our literature review group searched the databases Cinhal, Embase, Ovid, Pubmed, Web of Science, and WHO’s Index Medicus. The search terms included ‘thrombolytics’ AND ‘myocardial infarction’ AND ‘resource-limited’ and were restricted to human studies and papers written in English. A considerable number of studies came from Latin America; however, these studies were not written in English and were excluded. The initial search yielded 3,487 articles, which was reduced to 3,196 papers after titles were screened. Three medical professionals then screened abstracts, from which 291 articles were selected for full-text review and 94 papers were chosen for final inclusion. These articles were then analyzed and mapped geographically. Results: This systematic literature review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with 18 of 94 studies taking place in India. Furthermore, 13 studies occurred in Pakistan, followed by Iran (6), Sri Lanka (5), Brazil (4), China (4), and South Africa (4). Conclusion: Our systematic review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with the highest utilization occurring in India. This demonstrates that even though STK has high utility for STEMI treatment in resource-limited settings, it still has not become the standard of care. Future research should investigate the barriers preventing the establishment of STK use as second-line treatment after PCI.Keywords: cardiovascular disease, global health, resource-limited setting, ST-Elevation Myocardial Infarction, Streptokinase
Procedia PDF Downloads 1337173 Cyclic Heating Effect on Hardness of Copper
Authors: Tahany W. Sadak
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Presented work discusses research results concerning the effect of the heat treatment process. Thermal fatigue which expresses repeated heating and cooling processes affect the ductility or the brittleness of the material. In this research, 70 specimens of copper (1.5 mm thickness, 85 mm length, 32 mm width) are subjected to thermal fatigue at different conditions. Heating temperatures Th are 100, 300 and 500 °C. Number of repeated cycles N is from 1 to 100. Heating time th =600 Sec, and Cooling time; tC= 900 Sec. Results are evaluated and then compared to each other and to that of specimens without subjected to thermal fatigue.Keywords: copper, thermal analysis, heat treatment, hardness, thermal fatigue
Procedia PDF Downloads 4267172 Effects of Mild Heat Treatment on the Physical and Microbial Quality of Salak Apricot Cultivar
Authors: Bengi Hakguder Taze, Sevcan Unluturk
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Şalak apricot (Prunus armeniaca L., cv. Şalak) is a specific variety grown in Igdir, Turkey. The fruit has distinctive properties distinguish it from other cultivars, such as its unique size, color, taste and higher water content. Drying is the widely used method for preservation of apricots. However, fresh consumption is preferred for Şalak apricot instead of drying due to its low dry matter content. Higher amounts of water in the structure and climacteric nature make the fruit sensitive against rapid quality loss during storage. Hence, alternative processing methods need to be introduced to extend the shelf life of the fresh produce. Mild heat (MH) treatment is of great interest as it can reduce the microbial load and inhibit enzymatic activities. Therefore, the aim of this study was to evaluate the impact of mild heat treatment on the natural microflora found on Şalak apricot surfaces and some physical quality parameters of the fruit, such as color and firmness. For this purpose, apricot samples were treated at different temperatures between 40 and 60 ℃ for different periods ranging between 10 to 60 min using a temperature controlled water bath. Natural flora on the fruit surfaces was examined using standard plating technique both before and after the treatment. Moreover, any changes in color and firmness of the fruit samples were also monitored. It was found that control samples were initially containing 7.5 ± 0.32 log CFU/g of total aerobic plate count (TAPC), 5.8±0.31 log CFU/g of yeast and mold count (YMC), and 5.17 ± 0.22 log CFU/g of coliforms. The highest log reductions in TAPC and YMC were observed as 3.87-log and 5.8-log after the treatments at 60 ℃ and 50 ℃, respectively. Nevertheless, the fruit lost its characteristic aroma at temperatures above 50 ℃. Furthermore, great color changes (ΔE ˃ 6) were observed and firmness of the apricot samples was reduced at these conditions. On the other hand, MH treatment at 41 ℃ for 10 min resulted in 1.6-log and 0.91-log reductions in TAPC and YMC, respectively, with slightly noticeable changes in color (ΔE ˂ 3). In conclusion, application of temperatures higher than 50 ℃ caused undesirable changes in physical quality of Şalak apricots. Although higher microbial reductions were achieved at those temperatures, temperatures between 40 and 50°C should be further investigated considering the fruit quality parameters. Another strategy may be the use of high temperatures for short time periods not exceeding 1-5 min. Besides all, MH treatment with UV-C light irradiation can be also considered as a hurdle strategy for better inactivation results.Keywords: color, firmness, mild heat, natural flora, physical quality, şalak apricot
Procedia PDF Downloads 1287171 Pioglitazone Ameliorates Methotrexate-Induced Renal Endothelial Dysfunction via Amending Detrimental Changes in Antioxidant Profile, Systemic Cytokines and Apoptotic Factors
Authors: Sahar M. El-Gowilly, Mai M. Helmy, Hanan M. El-Gowelli
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Methotrexate (MTX) is widely used in treatment of cancers and autoimmune diseases. However, nephrotoxicity is one of the most important side effects of MTX. The peroxisome proliferator-activated receptor gamma agonist, pioglitazone (PIO), is known to exert anti-inflammatory and reno-protective effects in various kidney injuries. The purpose of this study was to investigate the potential involvement of endothelial damage in MTX-induced renal injury and to elaborate the possible protective effect of PIO against MTX-induced nephropathy. Compared with saline-treated rats, treatment with MTX (7 mg/kg for 3 day) caused significant elevations in serum levels of urea and creatinine, increased renal nitrate/nitrite level and impaired renovascular responsiveness of isolated perfused kidney to endothelium-dependent vasodilations induced by acetylcholine (0.01-2.43 nmol) and isoprenaline (1µmol). These effects were abolished by concurrent treatment with PIO (2.5 mg/kg, for 5 days starting two days before MTX). Alternatively, MTX treatment did not affect endothelium-independent renovascular relaxation induced by sodium nitroprusside (1-30 μmole). The possibility that alterations in renal antioxidants, circulating cytokine and apoptotic factor (Fas) levels contributed to MTX-PIO interaction was assessed. PIO treatment abrogated renal oxidative stress (decreased reduced glutathione and catalase activity and increased malondialdehyde), elevated serum cytokine (interleukin-6, interleukin-10, tumor necrosis factor-alpha and transforming growth factor-beta1) and Fas induced by MTX. Histologically, MTX caused defused tubular cells swelling and vacuolization associated with endothelial damage in renal arterioles. These effects disappeared upon co-treated with PIO. Collectively, PIO abolished MTX-induced endothelium dysfunction and nephrotoxicity via ameliorating oxidative stress and rectifying cytokines and Fas abnormalities caused by MTX.Keywords: methotrexate, pioglitazone, endothelium, kidney
Procedia PDF Downloads 3037170 Liquid Nitrogen as Fracturing Method for Hot Dry Rocks in Kazakhstan
Authors: Sotirios Longinos, Anna Loskutova, Assel Tolegenova, Assem Imanzhussip, Lei Wang
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Hot, dry rock (HDR) has substantial potential as a thermal energy source. It has been exploited by hydraulic fracturing to extract heat and generate electricity, which is a well-developed technique known for creating the enhanced geothermal systems (EGS). These days, LN2 is being tested as an environmental friendly fracturing fluid to generate densely interconnected crevices to augment heat exchange efficiency and production. This study examines experimentally the efficacy of LN2 cryogenic fracturing for granite samples in Kazakhstan with immersion method. A comparison of two different experimental models is carried out. The first mode is rock heating along with liquid nitrogen treatment (heating with freezing time), and the second mode is multiple times of heating along with liquid nitrogen treatment (heating with LN2 freezing-thawing cycles). The experimental results indicated that with multiple heating and LN2-treatment cycles, the permeability of granite first ameliorates with increasing number of cycles and later reaches a plateau after a certain number of cycles. On the other hand, density, P-wave velocity, uniaxial compressive strength, elastic modulus, and tensile strength indicate a downward trend with increasing heating and treatment cycles. The thermal treatment cycles do not seem to have an obvious effect on the Poisson’s ratio. The changing rate of granite rock properties decreases as the number of cycles increases. The deterioration of granite primarily happens within the early few cycles. The heating temperature during the cycles shows an important influence on the deterioration of granite. More specifically, mechanical deterioration and permeability amelioration become more remarkable as the heating temperature increases.LN2 fracturing generates many positives compared to conventional fracturing methods such as little water consumption, requirement of zero chemical additives, lessening of reservoir damage, and so forth. Based on the experimental observations, LN2 can work as a promising waterless fracturing fluid to stimulate hot, dry rock reservoirs.Keywords: granite, hydraulic fracturing, liquid nitrogen, Kazakhstan
Procedia PDF Downloads 1547169 Effect of Dietary Waste Date Meal (Phoneix dactylifera) on Chemical Body Composition, Nutrition Value and Fatty Acids Profile of Fingerling Common Carp (Cyprinus carpio)
Authors: Mehrdad Kamali-Sanzighi, Maziar Kamali-sanzighi
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Effect of waste date meal (WDM) addition to the diet on body chemical composition and fatty acids profile of fingerling cyprinus carpio were evaluated. Four treatments with 3 replication such as control treatment (no additional WDM; T1), 5% WDM (50 gr/kg; T2), 10% WDM (100 gr/kg; T3) and 15% WDM (150 gr/kg; T4) were done. 168 fish with initial weight of 2.48±0.06 gr were fed 3 times per day according to 5 % of fish body weight for 12 weeks. The body composition results showed that there is no significant differences between treatments (P>0.05). All of Fatty acids profile parameters show significant differences between different treatments (P<0.05). Although, the highest value of MUFA+PUFA, PUFA/SFA, MUFA+PUFA/SFA, W3, EPA+DHA parameters belong to control treatment (T1) and 5% WDM treatment (T2) had lowest value of MUFA, PUFA, MUFA+PUFA, PUFA/SFA, MUFA+PUFA/SFA, W3, W3/W6, DHA/EPA and EPA+DHA parameters except of SFA and W6/W3 that show highest value than other treatments. Atherogenic index (AI) had no significant differences between different treatments (P>0.05) but Thrombogenic index (TI) had significant differences between different experimental treatments (P<0.05). The 5% WDM and control treatment show highest and lowest values. Generally, treatments of 10 and 15% WDM (T3-T4) had moderate performance than the other experimental treatments. Finally, addition of WDM to common carp fingerlings diets help to insignificant improvement of chemical body composition and the saturated and unsaturated fatty acids profile of them were significant.Keywords: waste, date, common carp, nutrition value
Procedia PDF Downloads 837168 Comparison of Stereotactic Body Radiation Therapy Virtual Treatment Plans Obtained With Different Collimators in the Cyberknife System in Partial Breast Irradiation: A Retrospective Study
Authors: Öznur Saribaş, Si̇bel Kahraman Çeti̇ntaş
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It is aimed to compare target volume and critical organ doses by using CyberKnife (CK) in accelerated partial breast irradiation (APBI) in patients with early stage breast cancer. Three different virtual plans were made for Iris, fixed and multi-leaf collimator (MLC) for 5 patients who received radiotherapy in the CyberKnife system. CyberKnife virtual plans were created, with 6 Gy per day totaling 30 Gy. Dosimetric parameters for the three collimators were analyzed according to the restrictions in the NSABP-39/RTOG 0413 protocol. The plans ensured critical organs were protected and GTV received 95 % of the prescribed dose. The prescribed dose was defined by the isodose curve of a minimum of 80. Homogeneity index (HI), conformity index (CI), treatment time (min), monitor unit (MU) and doses taken by critical organs were compared. As a result of the comparison of the plans, a significant difference was found for the duration of treatment, MU. However, no significant difference was found for HI, CI. V30 and V15 values of the ipsi-lateral breast were found in the lowest MLC. There was no significant difference between Dmax values for lung and heart. However, the mean MU and duration of treatment were found in the lowest MLC. As a result, the target volume received the desired dose in each collimator. The contralateral breast and contralateral lung doses were the lowest in the Iris. Fixed collimator was found to be more suitable for cardiac doses. But these values did not make a significant difference. The use of fixed collimators may cause difficulties in clinical applications due to the long treatment time. The choice of collimator in breast SBRT applications with CyberKnife may vary depending on tumor size, proximity to critical organs and tumor localization.Keywords: APBI, CyberKnife, early stage breast cancer, radiotherapy.
Procedia PDF Downloads 1117167 Creation of a Clinical Tool for Diagnosis and Treatment of Skin Disease in HIV Positive Patients in Malawi
Authors: Alice Huffman, Joseph Hartland, Sam Gibbs
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Dermatology is often a neglected specialty in low-resource settings, despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV positive patients. African countries have the highest HIV infection rates and skin conditions are frequently misdiagnosed and mismanaged, because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV positive patients. A literature search within Embase, Medline and Google scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff a list of 15 skin conditions was included and a booklet created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff, alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.Keywords: dermatology, HIV, Malawi, skin disease
Procedia PDF Downloads 1777166 Effectiveness of Exercise and TENS in the Treatment of Temporomandibular Joint Disorders
Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku
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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise
Procedia PDF Downloads 2227165 Water Intake and Influence of Ambient Temperature on Carcass Characteristics of Savannah Brown Goats Fed Graded Levels of Maize Cob Diets Supplemented with Cowpea Husk
Authors: A. H. Dikko, D. N. Tsado, T. Z. Adama, Y. M. Ishiaku, S. U. Oyibo
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This study investigated water intake and influence of ambient temperature on carcass characteristics of Savannah Brown goats fed graded levels of maize cob diets. A total of sixteen (16) Savannah Brown goats aged between 8-12 weeks with an average body weight of 10.19+0.19 kg were used. The goats were randomly allotted to four (4) dietary treatments, T1 (0 % maize cob diet), T2 (10% maize cob diet), T3 (20% maize cob diet) and T4 (30% maize cob diet) respectively. The goats were also fed cowpea husk as supplement. A complete randomized design was used. Each treatment was allotted four (4) goats and replicated twice with two (2) goats per replicate. The goats were kept under feedlot management and were allowed 7 days adjustment period during which the animals were dewormed using albendzole and treated with antibiotics against any sign of disease(s). The goats were each offered 500 g of experimental diet between 7.00 am-8.00 am daily and the supplement was given to them between 4.00 pm-5.00 pm daily. The goats were offered three (3) litters of water daily without restriction. The experiment lasted for nine (9) weeks. Two (2) goats were randomly selected from each treatment and slaughtered for carcass characteristic and sensory evaluation. The result showed that ambient temperature had significant (P<0.05) correlations with water intake and feed intake among the treatment groups. There was a strongly positive significant (P<0.01) correlations between feed intake, water intake and ambient temperatures. The result on carcass characteristics showed significant (P<0.05) differences among all the treatment groups. The goats fed 20% maize cob performed significantly (P<0.05) better in most carcass cuts than those fed 0% inclusion level. Also, the result on sensory evaluation showed that colour, tenderness, juiciness and flavor for both cooked and fried meat were significantly (P<0.05) different among all the treatment groups. It can be concluded that 20 % inclusion of maize cob in the diet of Savanna Brown goats will improve meat yield and water intake. Therefore, inclusion of maize cob into the diet of Savanna Brown goats up to 20% is here by recommended.Keywords: water intake, ambient temperature, savannah brown goats, carcass
Procedia PDF Downloads 4277164 Pioglitazone Ameliorates Methotrexate-Induced Renal Endothelial Dysfunction via Amending Detrimental Changes in Antioxidant Profile, Systemic Cytokines and Fas Production
Authors: Sahar M. El-Gowilly, Mai M. Helmy, Hanan M. El-Gowelli
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Methotrexate (MTX) is widely used in treatment of cancers and autoimmune diseases. However, nephrotoxicity is one of its most important side effects. The peroxisome proliferator-activated receptor gamma agonist, pioglitazone, is known to exert antiinflammatory and reno-protective effects in various kidney injuries. The purpose of this study was to investigate the potential involvement of endothelial damage in MTX-induced renal injury and to elaborate the possible protective effect of pioglitazone against MTX-induced endothelial impairment. Compared with saline-treated rats, treatment with MTX (7 mg/kg for 3 day) caused significant elevations in serum levels of urea and creatinine, increased renal nitrate/nitrite level and impaired renovascular responsiveness of isolated perfused kidney to endothelium-dependent vasodilations induced by acetylcholine (0.01-2.43 nmol) and isoprenaline (1µmol). These effects were abolished by concurrent treatment with pioglitazone (2.5 mg/kg, for 5 days starting two days before MTX). Alternatively, MTX treatment did not affect endothelium-independent renovascular relaxation induced by sodium nitroprusside (0.001-10 μmole). The possibility that alterations in renal antioxidants, circulating cytokine and apoptotic factor (Fas) levels contributed to MTX-pioglitazone interaction was assessed. Pioglitazone treatment abrogated renal oxidative stress (decreased reduced glutathione and catalase activity and increased malondialdehyde), elevated serum cytokine (interleukin-6, interleukin-10, tumor necrosis factor-alpha and transforming growth factor-beta1) and Fas induced by MTX. Histologically, MTX caused defused tubular cells swelling and vacuolization associated with endothelial damage in renal arterioles. These effects disappeared upon co-treated with pioglitazone. Collectively, pioglitazone abolished MTX-induced endothelium dysfunction and nephrotoxicity via ameliorating oxidative stress and rectifying cytokines and Fas abnormalities caused by MTX.Keywords: methotrexate, pioglitazone, endothelium, kidney
Procedia PDF Downloads 4897163 The application of Gel Dosimeters and Comparison with other Dosimeters in Radiotherapy: A Literature Review
Authors: Sujan Mahamud
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Purpose: A major challenge in radiotherapy treatment is to deliver precise dose of radiation to the tumor with minimum dose to the healthy normal tissues. Recently, gel dosimetry has emerged as a powerful tool to measure three-dimensional (3D) dose distribution for complex delivery verification and quality assurance. These dosimeters act both as a phantom and detector, thus confirming the versatility of dosimetry technique. The aim of the study is to know the application of Gel Dosimeters in Radiotherapy and find out the comparison with 1D and 2D dimensional dosimeters. Methods and Materials: The study is carried out from Gel Dosimeter literatures. Secondary data and images have been collected from different sources such as different guidelines, books, and internet, etc. Result: Analyzing, verifying, and comparing data from treatment planning system (TPS) is determined that gel dosimeter is a very excellent powerful tool to measure three-dimensional (3D) dose distribution. The TPS calculated data were in very good agreement with the dose distribution measured by the ferrous gel. The overall uncertainty in the ferrous-gel dose determination was considerably reduced using an optimized MRI acquisition protocol and a new MRI scanner. The method developed for comparing measuring gel data with calculated treatment plans, the gel dosimetry method, was proven to be a useful for radiation treatment planning verification. In 1D and 2D Film, the depth dose and lateral for RMSD are 1.8% and 2%, and max (Di-Dj) are 2.5% and 8%. Other side 2D+ ( 3D) Film Gel and Plan Gel for RMSDstruct and RMSDstoch are 2.3% & 3.6% and 1% & 1% and system deviation are -0.6% and 2.5%. The study is investigated that the result fined 2D+ (3D) Film Dosimeter is better than the 1D and 2D Dosimeter. Discussion: Gel Dosimeters is quality control and quality assurance tool which will used the future clinical application.Keywords: gel dosimeters, phantom, rmsd, QC, detector
Procedia PDF Downloads 1437162 Exercise Intervention For Women After Treatment For Ovarian Cancer
Authors: Deirdre Mc Grath, Joanne Reid
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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.Keywords: ovarian cancer, exercise intervention, implementation, Co-design
Procedia PDF Downloads 1747161 Whole Body Cooling Hypothermia Treatment Modelling Using a Finite Element Thermoregulation Model
Authors: Ana Beatriz C. G. Silva, Luiz Carlos Wrobel, Fernando Luiz B. Ribeiro
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This paper presents a thermoregulation model using the finite element method to perform numerical analyses of brain cooling procedures as a contribution to the investigation on the use of therapeutic hypothermia after ischemia in adults. The use of computational methods can aid clinicians to observe body temperature using different cooling methods without the need of invasive techniques, and can thus be a valuable tool to assist clinical trials simulating different cooling options that can be used for treatment. In this work, we developed a FEM package applied to the solution of the continuum bioheat Pennes equation. Blood temperature changes were considered using a blood pool approach and a lumped analysis for intravascular catheter method of blood cooling. Some analyses are performed using a three-dimensional mesh based on a complex geometry obtained from computed tomography medical images, considering a cooling blanket and a intravascular catheter. A comparison is made between the results obtained and the effects of each case in brain temperature reduction in a required time, maintenance of body temperature at moderate hypothermia levels and gradual rewarming.Keywords: brain cooling, finite element method, hypothermia treatment, thermoregulation
Procedia PDF Downloads 3037160 Investigation of Microstructure of Differently Sub-Zero Treated Vanadis 6 Steel
Authors: J. Ptačinová, J. Ďurica, P. Jurči, M Kusý
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Ledeburitic tool steel Vanadis 6 has been subjected to sub-zero treatment (SZT) at -140 °C and -196 °C, for different durations up to 48 h. The microstructure and hardness have been examined with reference to the same material after room temperature quenching, by using the light microscopy, scanning electron microscopy, X-ray diffraction, and Vickers hardness testing method. The microstructure of the material consists of the martensitic matrix with certain amount of retained austenite, and of several types of carbides – eutectic carbides, secondary carbides, and small globular carbides. SZT reduces the retained austenite amount – this is more effective at -196 °C than at -140 °C. Alternatively, the amount of small globular carbides increases more rapidly after SZT at -140 °C than after the treatment at -140 °C. The hardness of sub-zero treated material is higher than that of conventionally treated steel when tempered at low temperature. Compressive hydrostatic stresses are developed in the retained austenite due to the application of SZT, as a result of more complete martensitic transformation. This is also why the population density of small globular carbides is substantially increased due to the SZT. In contrast, the hardness of sub-zero treated samples decreases more rapidly compared to that of conventionally treated steel, and in addition, sub-zero treated material induces a loss the secondary hardening peak.Keywords: microstructure, Vanadis 6 tool steel, sub-zero treatment, carbides
Procedia PDF Downloads 1567159 Influence of Boron Doping and Thermal Treatment on Internal Friction of Monocrystalline Si1-xGex(x≤0,02) Alloys
Authors: I. Kurashvili, G. Darsavelidze, G. Bokuchava, A. Sichinava, I. Tabatadze
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The impact of boron doping on the internal friction (IF) and shear modulus temperature spectra of Si1-xGex(x≤0,02) monocrsytals has been investigated by reverse torsional pendulum oscillations characteristics testing. At room temperatures, microhardness and indentation modulus of the same specimens have been measured by dynamic ultra microhardness tester. It is shown that boron doping causes two kinds effect: At low boron concentration (~1015 cm-3) significant strengthening is revealed, while at the high boron concentration (~1019 cm-3) strengthening effect and activation characteristics of relaxation origin IF processes are reduced.Keywords: boron, doping, internal friction, si-ge alloys, thermal treatment
Procedia PDF Downloads 4497158 The Role of Midwives in Promoting Childbearing in Respect to the Law of Population Youth in Iran
Authors: Parvin Abedi, Poorandokht Afshari
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Introduction: In 2022, the Youth Law of the Population was notified to all organizations, including the Iranian Ministry of Health. Some of the articles of this law are about the role of midwives in health and treatment to promote childbearing. In this regard, articles number 45, 48, 49, and 50 are related to midwifery work that will be reviewed in this article. Methods: In this review, the law of population youth was reviewed. In this regard, the statistics of midwives working in the treatment and health sector were collected and analyzed according to the population youth law. Results: Nearly 47 000 midwives are working in the public and private sectors of the country and in the healthcare sector; according to Article 49, which states that there should be one midwife for every two parturient women, about 12,000 midwives are needed in the treatment department and about 8,000 midwives are needed in the health department. In Article 50 it is mentioned to modify tariffs and efficiency in order to increase natural childbirth, and in this field, insurance organizations should have sufficient cooperation with payments. The tariff for midwifery services has been increased, but it is not enough for the stressful job of midwifery. The labor incentive for delivery by midwives is also low. Conclusion: Midwives are one of the fundamental pillars of the law of the population, and without increasing the motivation of midwives, it is not possible to increase the rate of natural childbirth and make childbirth pleasant.Keywords: law of the population, midwife, motivation, childbearing
Procedia PDF Downloads 287157 The Effect of Dissociation in Bipolar Disorder: An EEG Power Analysis
Authors: Merve Cebi, Turker Tekin Erguzel, Gokben Hizli Sayar
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Understanding the biological mechanisms of dissociation in patients with bipolar disorder is important for developing new treatment approaches for the disorder as well as using the appropriate treatment strategies. In this study, we compared EEG power and coherence values for alpha, theta and beta frequency bands between patients having bipolar disorder with dissociation as compared to the bipolar patients without dissociation. Accordingly, we did not find any statistically significant difference in either the absolute or the relative power between the groups. Coherence values were not found to be statistically different, as well. Therefore, our results demonstrated that the existence of dissociation did not influence electrophysiological correlates in bipolar disorder.Keywords: bipolar disorder, dissociation, absolute power, coherence
Procedia PDF Downloads 5757156 Human Quality Treatment and Organizational Growth: The Principle of Respect at Nestle Nigeria
Authors: Rose Ogbechie, Nicholas Anakwue
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In recent times, research has centered, in the area of Business Ethics, on the issue of human quality treatment (HQT), regarding the way people are dealt with, in organizations, taking into cognizance, respect for the dignity of the human person, as well as, the rights and responsibilities of the corporate individual. As such, the principle of respect is an essential ethical principle that should govern professional relationships in the workplace. There is a prevailing myth in the Nigerian business space, that to drive business success, business leadership must coerce and drive people, oftentimes, beyond comfort to meet work expectations. This has, most times, necessitated abuses and insults on subordinates in the workplace, and instituted a rigid hierarchy of management in business relationships. Nestlé Nigeria, one of the largest foods and beverage companies in Africa, provides a contrast to this myth in their success heuristic. Over the years in Nigeria, the company has registered significant successes in the Nigerian Fast-Moving Consumer Goods (FMCG) Market, with stellar performances year-on-year, and a high-penetration rate of its products in the Nigerian consumer space. At the heart of the FMCG giant’s success and culture is the principle of respect—respect for stakeholders, respect for all peoples, respect for cultures, respect for the environment. Utilizing qualitative research methods, through interviews and focus group discussions with Nestlé’s stakeholders, this paper explores the ethical principle of respect, and how, through it, human quality treatment influences positively organizational growth.Keywords: human quality treatment, respect, Nestlé Nigeria, FMCG, organizational growth
Procedia PDF Downloads 1077155 Inverted Diameter-Limit Thinning: A Promising Alternative for Mixed Populus tremuloides Stands Management
Authors: Ablo Paul Igor Hounzandji, Benoit Lafleur, Annie DesRochers
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Introduction: Populus tremuloides [Michx] regenerates rapidly and abundantly by root suckering after harvest, creating stands with interconnected stems. Pre-commercial thinning can be used to concentrate growth on fewer stems to reach merchantability faster than un-thinned stands. However, conventional thinning methods are typically designed to reach even spacing between residual stems (1,100 stem ha⁻¹, evenly distributed), which can lead to treated stands consisting of weaker/smaller stems compared to the original stands. Considering the nature of P. tremuloides's regeneration, with large underground biomass of interconnected roots, aiming to keep the most vigorous and largest stems, regardless of their spatial distribution, inverted diameter-limit thinning could be more beneficial to post-thinning stand productivity because it would reduce the imbalance between roots and leaf area caused by thinning. Aims: This study aimed to compare stand and stem productivity of P. tremuloides stands thinned with a conventional thinning treatment (CT; 1,100 stem ha⁻¹, evenly distributed), two levels of inverted diameter-limit thinning (DL1 and DL2, keeping the largest 1100 or 2200 stems ha⁻¹, respectively, regardless of their spatial distribution) and a control unthinned treatment. Because DL treatments can create substantial or frequent gaps in the thinned stands, we also aimed to evaluate the potential of this treatment to recreate mixed conifer-broadleaf stands by fill-planting Picea glauca seedlings. Methods: Three replicate 21 year-old sucker-regenerated aspen stands were thinned in 2010 according to four treatments: CT, DL1, DL2, and un-thinned control. Picea glauca seedlings were underplanted in gaps created by the DL1 and DL2 treatments. Stand productivity per hectare, stem quality (diameter and height, volume stem⁻¹) and survival and height growth of fill-planted P. glauca seedlings were measured 8 year post-treatments. Results: Productivity, volume, diameter, and height were better in the treated stands (CT, DL1, and DL2) than in the un-thinned control. Productivity of CT and DL1 stands was similar 4.8 m³ ha⁻¹ year⁻¹. At the tree level, diameter and height of the trees in the DL1 treatment were 5% greater than those in the CT treatment. The average volume of trees in the DL1 treatment was 11% higher than the CT treatment. Survival after 8 years of fill planted P. glauca seedlings was 2% greater in the DL1 than in the DL2 treatment. DL1 treatment also produced taller seedlings (+20 cm). Discussion: Results showed that DL treatments were effective in producing post-thinned stands with larger stems without affecting stand productivity. In addition, we showed that these treatments were suitable to introduce slower growing conifer seedlings such as Picea glauca in order to re-create or maintain mixed stands despite the aggressive nature of P. tremuloides sucker regeneration.Keywords: Aspen, inverted diameter-limit, mixed forest, populus tremuloides, silviculture, thinning
Procedia PDF Downloads 1387154 Fracture Dislocation of Upper Sacrum in an Adolescent: Case Report and Review of Literature
Authors: S. Alireza Mirghasemi, Narges Rahimi Gabaran
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Although sacral fractures in children are rare due to the fact that the occurrence of pelvic fracture is not common in childhood. Sacral fractures present a high risk of neurological damage. This kind of fracture is often missed because the routine pelvic X-rays imaging scarcely show this fracture. Also, the treatment is controversial, and it ranges from fine reduction to conservative treatments without any try to reduce the dislocation. In this article, a case of fracture dislocation of S1 and S2 along with a suggested diagnostic test and treatment based on similar cases are presented. The case investigates a 14-year-old boy who entered the hospital one week after a car accident that knocked him to the ground in crawling position and a rack fell down on his body. Pain and tenderness in the sacral region and a fracture in the left leg were notable--we detected incomplete bilateral palsy of L5, S1 and S2 roots. In radiographs of the spine fracture dislocation of S1, the sacral fracture was seen. The treatment included a skeletal traction with a halo over the patient’s head and two femoral pins. After one week, another surgery was performed in order to stabilize and reduce the fracture, and we employed a posterior approach with CD and a pedicular screw. After two years of follow-up, the fracture is completely cured without any loss of reduction.Keywords: adolescent, fracture in adolescent, fracture dislocation, sacrum
Procedia PDF Downloads 2837153 Harnessing Microorganism Having Potential for Biotreatment of Wastewater
Authors: Haruna Saidu, Sulaiman Mohammed, Abdulkarim Ali Deba, Shaza Eva Mohamad
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Determining the diversity of the indigenous microorganisms in Palm Oil Mill Effluent (POME) could allow their wider application for the treatment of recalcitrant agro-based wastewater discharge into the environment. Many research studies mainly determined the efficiency of microorganism or their co-cultivation with microalgae for enhanced treatment of wastewater, suggesting a limited emphasis on the application of microbial diversity. In this study, the microorganism was cultured in POME for a period of 15 days using microalgae as a source of carbon. Pyrosequencing analysis reveals a diversity of microbial community in 20% (v/v) culture than the control experiment. Most of the bacterial species identified in POME belong to the families of Bacillaceae, Paenibacillaceae, Enterococcaceae, Clostridiaceae, Peptostreptococcaceae, Caulobacteraceae, Enterobacteriaceae, Moraxellaceae, and Pseudomonadaceae. Alpha (α) diversity analysis reveals the high composition of the microbial community of 52 in both samples. Beta (β) diversity index indicated the occurrence of similar species of microorganisms in unweighted uni fra than the weighted uni fra of both samples. It is therefore suggested that bacteria found in these families could have a potential for synergistic treatment of high-strength wastewater generated from the palm oil industry.Keywords: diversity, microorganism, wastewater, pyrosequencing, palm oil mill effluent
Procedia PDF Downloads 187152 The Multidisciplinary Treatment in Residence Care Clinic for Treatment of Feeding and Eating Disorders
Authors: Yuri Melis, Mattia Resteghini, Emanuela Apicella, Eugenia Dozio, Leonardo Mendolicchio
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Aim: This retrospective study was created to analyze the psychometric, anthropometric and body composition values in patients at the beginning and the discharge of their of hospitalization in the residential care clinic for eating and feeding disorders (EFD’s). Method: The sample was composed by (N=59) patients with mean age N= 33,50, divided in subgroups: Anorexia Nervosa (AN) (N=28), Bulimia Nervosa (BN) (N=13) and Binge Eating Disorders (BED) (N=14) recruited from a residential care clinic for eating and feeding disorders. The psychometrics level was measured with self-report questionnaires: Eating Disorders Inventory-3 (EDI-3) The Body Uneasiness Test (BUT), Minnesota Multiphasic Personality Inventory (MMPI – 2). The anthropometric and nutritional values was collected by Body Impedance Assessment (B.I.A), Body mass index (B.M.I.). Measurements were made at the beginning and at the end of hospitalization, with an average time of recovery of about 8,6 months. Results: The all data analysis showed a statistical significance (p-value >0,05 | power size N=0,950) in variation from T0 (start of recovery) to T1 (end of recovery) in the clinical scales of MMPI-2, AN group (Hypocondria T0 64,14 – T1 56,39) (Depression T0 72,93 – T1 59,50) (Hysteria T0 61,29 – T1 56,17) (Psychopathic deviation T0 64,00 – T1 60,82) (Paranoia T0 63,82 – T1 56,14) (Psychasthenia T0 63,82 – T1 57,86) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 60,36 – T1 55,68); BN group (Hypocondria T0 64,08 – T1 47,54) (Depression T0 67,46 – T1 52,46) (Hysteria T0 60,62 – T1 47,84) (Psychopathic deviation T0 65,69 – T1 58,92) (Paranoia T0 67,46 – T1 55,23) (Psychasthenia T0 60,77 – T1 53,77) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 62,92 – T1 54,08); B.E.D groups (Hypocondria T0 59,43 – T1 53,14) (Depression T0 66,71 – T1 54,57) (Hysteria T0 59,86 – T1 53,82) (Psychopathic deviation T0 67,39 – T1 59,03) (Paranoia T0 58,57 – T1 53,21) (Psychasthenia T0 61,43 – T1 53,00) (Schizophrenia T0 62,29 – T1 56,36) (Obsessive T0 58,57 – T1 48,64). EDI-3 report mean value is higher than clinical cut-off at T0, in T1, there is a significant reduction of the general mean of value. The same result is present in the B.U.T. test in the difference between T0 to T1. B.M.I mean value in AN group is (T0 14,83 – T1 18,41) BN group (T0 20 – T1 21,33) BED group (T0 42,32 – T1 34,97) Phase Angle results: AN group (T0 4,78 – T1 5,64) BN (T0 6 – T1 6,53) BED group (T0 6 – T1 6,72). Discussion and conclusion: The evident presence that on the whole sample, we have an altered serious psychiatric and clinic conditions at the beginning of recovery. The interesting conclusions that we can draw from this analysis are that a multidisciplinary approach that includes the entire care of the subject: from the pharmacological treatment, analytical psychotherapy, Psychomotricity, nutritional rehabilitation, and rehabilitative, educational activities. Thus, this Multidisciplinary treatment allows subjects in our sample to be able to restore psychopathological and metabolic values to below the clinical cut-off.Keywords: feeding and eating disorders, anorexia nervosa, care clinic treatment, multidisciplinary treatment
Procedia PDF Downloads 1167151 Geopolymerization Methods for Clay Soils Treatment
Authors: Baba Hassane Ahmed Hisseini, Abdelkrim Bennabi, Rabah Hamzaoui, Lamis Makki, Gaetan Blanck
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Most of the clay soils are known as problematic soils due to their water content, which varies greatly over time. It is observed that they are used to be subject to shrinkage and swelling, thus causing a problem of stability on the structures of civil engineering construction work. They are often excavated and placed in a storage area giving rise to the opening of new quarries. This method has become obsolete today because to protect the environment, we are leading to think differently and opening the way to new research for the improvement of the performance of this type of clay soils to reuse them in the construction field. The solidification and stabilization technique is used to improve the properties of poor quality soils to transform them into materials with a suitable performance for a new use in the civil engineering field rather than to excavate them and store them in the discharge area. In our case, the polymerization method is used for bad clay soils classified as high plasticity soil class A4 according to the French standard NF P11-300, where classical treatment methods with cement or lime are not efficient. Our work concerns clay soil treatment study using raw materials as additives for solidification and stabilization. The geopolymers are synthesized by aluminosilicates materials like fly ash, metakaolin, or blast furnace slag and activated by alkaline solution based on sodium hydroxide (NaOH), sodium silicate (Na2SiO3) or a mixture of both of them. In this study, we present the mechanical properties of the soil clay (A4 type) evolution with geopolymerisation methods treatment. Various mix design of aluminosilicates materials and alkaline solutions were carried at different percentages and different curing times of 1, 7, and 28 days. The compressive strength of the untreated clayey soil could be increased from simple to triple. It is observed that the improvement of compressive strength is associated with a geopolymerization mechanism. The highest compressive strength was found with metakaolin at 28 days.Keywords: treatment and valorization of clay-soil, solidification and stabilization, alkali-activation of co-product, geopolymerization
Procedia PDF Downloads 1527150 Effects of Nitrogen and Arsenic on Antioxidant Enzyme Activities and Photosynthetic Pigments in Safflower (Carthamus tinctorius L.)
Authors: Mostafa Heidari
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Nitrogen fertilization has played a significant role in increasing crop yield, and solving problems of hunger and malnutrition worldwide. However, excessive of heavy metals such as arsenic can interfere on growth and reduced grain yield. In order to investigate the effects of different concentrations of arsenic and nitrogen fertilizer on photosynthetic pigments and antioxidant enzyme activities in safflower (cv. Goldasht), a factorial plot experiment as randomized complete block design with three replication was conducted in university of Zabol. Arsenic treatment included: A1= control or 0, A2=30, A3=60 and A4=90 mg. kg-1 soil from the Na2HASO4 source and three nitrogen levels including W1=75, W2=150 and W3=225 kg.ha-1 from urea source. Results showed that, arsenic had a significant effect on the activity of antioxidant enzymes. By increasing arsenic levels from A1 to A4, the activity of ascorbate peroxidase (APX) and gayacol peroxidase (GPX) increased and catalase (CAT) was decreased. In this study, arsenic had no significant on chlorophyll a, b and cartoneid content. Nitrogen and interaction between arsenic and nitrogen treatment, except APX, had significant effect on CAT and GPX. The highest GPX activity was obtained at A4N3 treatment. Nitrogen increased the content of chlorophyll a, b and cartoneid.Keywords: arsenic, physiological parameters, oxidative enzymes, nitrogen
Procedia PDF Downloads 4347149 Robot-Assisted Therapy for Autism Spectrum Disorder: Evaluating the Impact of NAO Robot on Social and Language Skills
Authors: M. Aguilar, D. L. Araujo, A. L. Avendaño, D. C. Flores, I. Lascurain, R. A. Molina, M. Romero
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This work presents an application of social robotics, specifically the use of a NAO Robot as a tool for therapists in the treatment of Autism Spectrum Disorder (ASD). According to this, therapies approved by specialist psychologists have been developed and implemented, focusing on creating a triangulation between the robot, the child, and the therapist, aiming to improve their social and language skills, as well as communication skills and joint attention. In addition, quantitative and qualitative analysis tools have been developed and applied to prove the acceptance and the impact of the robot in the treatment of ASD.Keywords: autism spectrum disorder, NAO robot, social and language skills, therapy
Procedia PDF Downloads 1177148 Study of the Efficacy of Cysteine Protease Inhibitors Alone or Combined with Praziquantel as Chemotherapy for Mice Schistosomiasis mansoni
Authors: Alyaa Ahmed Farid, Aida Ismail, Ibrahim Rabia, Azza Fahmy, Azza El Amir
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This study was designed for assessment of 3 types of Cysteine protease inhibitors (CPIs) fluromethylketone (FMK), vinyl sulfone (VS) and sodium nitro prussid (SNP), to define which of them is the best? The experiments aimed to define the protective power of each inhibitor alone or combined with PZQ for curing S. mansoni infection in mice. In vitro, treated S. mansoni adult worms recorded a mortality rate after 1 hr of exposure to 500 ppm of FMK, VS and SNP as 75, 70 and 60%, while, treated cercaria recorded 75, 60 and 50%, respectively. FMK+PZQ treatment recorded the maximum reduction in worm burden (97.2% at 5 wk PI). VS treatment alone or combined with PZQ increases IgM, total IgG, IgG2 and IgG4 levels. In EM study of worm tegument, while only detachment of spines was observed in PZQ treated group, the completely implanted spines were reported in the degenerated tegument of adult worms in all groups treated with CPIs. Treatment with VS+PZQ increased Igs levels but, its effect was different on worm reduction. So, it is not enough to eliminate the infection and FMK+PZQ considered the antischistosomicidal drug of choice.Keywords: praziquantel, fluromethylketone, vinyl sulfone, worm burden, immunoglobulin pattern
Procedia PDF Downloads 3617147 Efficacy and Safety of Combination Therapy in Androgenetic Alopecia: Randomized Uncontrolled Evaluator, Blind Study
Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh
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Introduction: Early age of onset of baldness has marked psychological impact on personality. Combination therapies have better efficacy than monotherapy in androgenetic alopecia. Although medical, surgical treatment and cosmetic aids are available for treatment of pattern baldness, medical is first preferred the line of treatment. Although only 5% topical minoxidil is USFDA approved, 10% is available in India since 2007. Efficacy of tablet finasteride is well established in male pattern baldness. 5% topical minoxidil is effective and safe in female pattern baldness. There is a role of saw palmetto in regrowth of scalp hair. With this background research was undertaken to study efficacy and safety of topical minoxidil 10% + tab. Finesteride (1mg) + dermaroller in male pattern baldness and topical minoxidil 5% + cap. Saw palmetto (320 mg) + dermaroller in female pattern baldness. Methods and Materials: It was a randomized uncontrolled evaluator blind study consisting of total 21 patients, 15 of male pattern baldness and 6 of female pattern baldness within 20-35 yrs of age were enrolled. Male patients had Hamilton grade 2-4 MPB and females had Ludwig grade 2 FPB. Male patients were treated with Tab Finesteride 1mg once daily + 10% topical Minoxidil 1ml twice daily for 6 months. Female patients were treated with Cap. Saw palmetto 320 mg once daily + 5% topical Minoxidil twice daily for 6 months. In both male & female patients dermaroller therapy was used once in 10 days for 4 sittings followed by once in 15 days for next 5 months. Blood pressure and possible side effects were monitored in every follow up visits. Pre and post treatment photographs were taken. Assessment of hair growth was done at baseline and at the end of 6 months. Patients satisfactory grading scale and Physician assessment of hair growth scale were used to assessing the results. Trichoscan was done for assessment of hair-shaft diameter and density. Pre and post treatment photographs and Trichoscan hair growth analysis (by diameter and density) was done by physician (dermatologist) not directly involved in this study (evaluator blind). Result: This combination therapy showed moderate response in female pattern alopecia and good to excellent results in male pattern alopecia at the end of 6 months. During therapy none of the patients showed side effects like hypotension, headache and loss of libido, hirsuitism. Mild irritation due to crystal deposition was noted by 3 patients. Conclusion: Effective and early treatment using combination therapy with higher percent of Minoxidil for rapid hair growth is necessary in initial period since it will boost up the self-confidence in patients leading to better treatment compliance. Subsequent maintenance of hair growth can be done with lower concentration. No significant side effects with treatment are observed in both group of patients.Keywords: androgenetic alopecia, dermaroller, finasteride, minoxidil, saw palmetto
Procedia PDF Downloads 2387146 Environmental Pollution and Treatment Technology
Authors: R. Berrached, H. Ait Mahamed, A. Iddou
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Water pollution is nowadays a serious problem, due to the increasing scarcity of water and thus to the impact induced by such pollution on the human health. Various techniques are made use of to deal with water pollution. Among the most used ones, some can be enumerated: the bacterian bed, the activated mud, the Lagunage as biological processes and coagulation-floculation as a physic-chemical process. These processes are very expensive and an treatment efficiency which decreases along with the increase of the initial pollutants’ concentration. This is the reason why research has been reoriented towards the use of a process by adsorption as an alternative solution instead of the other traditional processes. In our study, we have tempted to exploit the characteristics of two metallic hydroxides Al and Fe to purify contaminated water by two industrial dyes SBL blue and SRL-150 orange. Results have shown the efficiency of the two materials on the blue SBL dye.Keywords: metallic hydroxydes, industrial dyes, purificatıon,
Procedia PDF Downloads 3177145 Real-World Comparison of Adherence to and Persistence with Dulaglutide and Liraglutide in UAE e-Claims Database
Authors: Ibrahim Turfanda, Soniya Rai, Karan Vadher
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Objectives— The study aims to compare real-world adherence to and persistence with dulaglutide and liraglutide in patients with type 2 diabetes (T2D) initiating treatment in UAE. Methods— This was a retrospective, non-interventional study (observation period: 01 March 2017–31 August 2019) using the UAE Dubai e-Claims database. Included: adult patients initiating dulaglutide/liraglutide 01 September 2017–31 August 2018 (index period) with: ≥1 claim for T2D in the 6 months before index date (ID); ≥1 claim for dulaglutide/liraglutide during index period; and continuous medical enrolment for ≥6 months before and ≥12 months after ID. Key endpoints, assessed 3/6/12 months after ID: adherence to treatment (proportion of days covered [PDC; PDC ≥80% considered ‘adherent’], per-group mean±standard deviation [SD] PDC); and persistence (number of continuous therapy days from ID until discontinuation [i.e., >45 days gap] or end of observation period). Patients initiating dulaglutide/liraglutide were propensity score matched (1:1) based on baseline characteristics. Between-group comparison of adherence was analysed using the McNemar test (α=0.025). Persistence was analysed using Kaplan–Meier estimates with log-rank tests (α=0.025) for between-group comparisons. This study presents 12-month outcomes. Results— Following propensity score matching, 263 patients were included in each group. Mean±SD PDC for all patients at 12 months was significantly higher in the dulaglutide versus the liraglutide group (dulaglutide=0.48±0.30, liraglutide=0.39±0.28, p=0.0002). The proportion of adherent patients favored dulaglutide (dulaglutide=20.2%, liraglutide=12.9%, p=0.0302), as did the probability of being adherent to treatment (odds ratio [97.5% CI]: 1.70 [0.99, 2.91]; p=0.03). Proportion of persistent patients also favoured dulaglutide (dulaglutide=15.2%, liraglutide=9.1%, p=0.0528), as did the probability of discontinuing treatment 12 months after ID (p=0.027). Conclusions— Based on the UAE Dubai e-Claims database data, dulaglutide initiators exhibited significantly greater adherence in terms of mean PDC versus liraglutide initiators. The proportion of adherent patients and the probability of being adherent favored the dulaglutide group, as did treatment persistence.Keywords: adherence, dulaglutide, effectiveness, liraglutide, persistence
Procedia PDF Downloads 115