Search results for: newborn hearing screening
670 The Study of Effective Microorganism's Biopreperation for Wastewater Treatment
Authors: Batsukh Chultem, Oyunbileg Natsagdorj, Namsrai Steyrmunkh
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Many industries, tourist camps and houses, discharge aqueous effluents containing relatively high levels of heavy metals, harmful organic compounds water. Untreated effluent from these manufacturing processes has an adverse impact on the environment. A specific problem associated with waste water in the environment is accumulation in the food chain and persistence in the environment. The screening of microorganisms resistant to pollution and able to detoxification them is essential for the development of clean-up technologies. The purpose of this study is to use advanced microbiological technology products for oxidizing organic and heavy metals pollutants as a biological treatment, to reduce water pollution, which arise as a result of waste water due to day-to-day operations of industries and houses of Ulaanbaatar city and tourist camps located around the lake Hovsgol, in Hovsgol province of Mongolia. By comparing the results from tests of effective microorganism’s bio-preparation treated sewage samples and not treated sewage samples shows that the treated sewage samples pollution decreased defending on treatment period and ratio. Treated water analyses show that: the suspended solids 352 mg/l, pH 5.85-7.95, ammonium nitrate 81.25-221.2 mg NH₄/l, nitrite 0.088-0.227 mg NO₂/l, nitrate 8.5-11.5 mg NO₃/l, and orthophosphate 1.06-15.46 mg PO₄/l. Also, heavy metals were decreased and microbiological test results defined parameters, respectively show the waste water pollution was reduced.Keywords: effective microorganims, environment, pollution, treatment
Procedia PDF Downloads 130669 Simulation Study of Enhanced Terahertz Radiation Generation by Two-Color Laser Plasma Interaction
Authors: Nirmal Kumar Verma, Pallavi Jha
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Terahertz (THz) radiation generation by propagation of two-color laser pulses in plasma is an active area of research due to its potential applications in various areas, including security screening, material characterization and spectroscopic techniques. Due to non ionizing nature and the ability to penetrate several millimeters, THz radiation is suitable for diagnosis of cancerous cells. Traditional THz emitters like optically active crystals when irradiated with high power laser radiation, are subject to material breakdown and hence low conversion efficiencies. This problem is not encountered in laser - plasma based THz radiation sources. The present paper is devoted to the simulation study of the enhanced THz radiation generation by propagation of two-color, linearly polarized laser pulses through magnetized plasma. The two laser pulses orthogonally polarized are co-propagating along the same direction. The direction of the external magnetic field is such that one of the two laser pulses propagates in the ordinary mode, while the other pulse propagates in the extraordinary mode through homogeneous plasma. A transverse electromagnetic wave with frequency in the THz range is generated due to the presence of the static magnetic field. It is observed that larger amplitude terahertz can be generated by mixing of ordinary and extraordinary modes of two-color laser pulses as compared with a single laser pulse propagating in the extraordinary mode.Keywords: two-color laser pulses, terahertz radiation, magnetized plasma, ordinary and extraordinary mode
Procedia PDF Downloads 300668 Screening Deformed Red Blood Cells Irradiated by Ionizing Radiations Using Windowed Fourier Transform
Authors: Dahi Ghareab Abdelsalam Ibrahim, R. H. Bakr
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Ionizing radiation, such as gamma radiation and X-rays, has many applications in medical diagnoses and cancer treatment. In this paper, we used the windowed Fourier transform to extract the complex image of the deformed red blood cells. The real values of the complex image are used to extract the best fitting of the deformed cell boundary. Male albino rats are irradiated by γ-rays from ⁶⁰Co. The male albino rats are anesthetized with ether, and then blood samples are collected from the eye vein by heparinized capillary tubes for studying the radiation-damaging effect in-vivo by the proposed windowed Fourier transform. The peripheral blood films are prepared according to the Brown method. The peripheral blood film is photographed by using an Automatic Image Contour Analysis system (SAMICA) from ELBEK-Bildanalyse GmbH, Siegen, Germany. The SAMICA system is provided with an electronic camera connected to a computer through a built-in interface card, and the image can be magnified up to 1200 times and displayed by the computer. The images of the peripheral blood films are then analyzed by the windowed Fourier transform method to extract the precise deformation from the best fitting. Based on accurate deformation evaluation of the red blood cells, diseases can be diagnosed in their primary stages.Keywords: windowed Fourier transform, red blood cells, phase wrapping, Image processing
Procedia PDF Downloads 84667 Branding Tourism Destinations; The Trending Initiatives for Edifice Image Choices of Foreign Policy
Authors: Mehtab Alam, Mudiarasan Kuppusamy, Puvaneswaran Kunaserkaran
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The purpose of this paper is to bridge the gap and complete the relationship between tourism destinations and image branding as a choice of edifice foreign policy. Such options became a crucial component for individuals interested in leisure and travel activities. The destination management factors have been evaluated and analyzed using the primary and secondary data in a mixed-methods approach (quantitative sample of 384 and qualitative 8 semi-structured interviews at saturated point). The study chose the Environmental Management Accounting (EMA) and Image Restoration (IR) theories, along with a schematic diagram and an analytical framework supported by NVivo software 12, for two locations in Abbottabad, KPK, Pakistan: Shimla Hill and Thandiani. This incorporates the use of PLS-SEM model for assessing validity of data while SPSS for data screening of descriptive statistics. The results show that destination management's promotion of tourism has significantly improved Pakistan's state image. The use of institutional setup, environmental drivers, immigration, security, and hospitality as well as recreational initiatives on destination management is encouraged. The practical ramifications direct the heads of tourism projects, diplomats, directors, and policymakers to complete destination projects before inviting people to Pakistan. The paper provides the extent of knowledge for academic tourism circles to use tourism destinations as brand ambassadors.Keywords: tourism, management, state image, foreign policy, image branding
Procedia PDF Downloads 68666 Quality Evaluation of Treated Ballast Seawater for Potential Reuse
Authors: Siti Nur Muhamad, Mohamad Abu Ubaidah Amir, Adenen Shuhada Abdul Aziz, Siti Sarah Mohd Isnan, Ainul Husna Abdul Rahman, Nur Afiqah Rosly, Roshamida Abd Jamil
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The International Convention for the Control and Management of Ships’ Ballast Water and Sediments (BWM Convention) will commencing on 8 September 2017 after ratified by 51 States in September 2016. However, there is no value recovered for the treated ballast water as it simply discharged during de-ballasting. In order to evaluate value creation of treated ballast water, three seawater applications which are seawater toilet flushing, cooling tower and desalination was studied and compared with treated ballast seawater. An exploratory study was conducted in Singapore as a case study as this country is facing water scarcity issues and a busy port in the world which received more than 28 billion m3 of ballast water in 2015. Surprisingly the treatment technology between seawater toilet flushing and ballast water management has similarity as both applications use screening and disinfection process and quality standard and analysis between treated ballast water with seawater applications found that seawater toilet flushing have the same quality parameter with treated ballast water. Thus, the treated ballast water can replace the raw seawater for seawater desalination. As such, with reduction of cost for screen unit, desalination water can exceed water production by NEWater in Singapore as the cost can recover the energy needed for desalination. It can conclude that treated ballast water has high recovery value and can be reused in seawater application.Keywords: ballast water treatment, desalination, BWM convention, ballast water management
Procedia PDF Downloads 376665 Enhancement of Rice Straw Composting Using UV Induced Mutants of Penicillium Strain
Authors: T. N. M. El Sebai, A. A. Khattab, Wafaa M. Abd-El Rahim, H. Moawad
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Fungal mutant strains have produced cellulase and xylanase enzymes, and have induced high hydrolysis with enhanced of rice straw. The mutants were obtained by exposing Penicillium strain to UV-light treatments. Screening and selection after treatment with UV-light were carried out using cellulolytic and xylanolytic clear zones method to select the hypercellulolytic and hyperxylanolytic mutants. These mutants were evaluated for their cellulase and xylanase enzyme production as well as their abilities for biodegradation of rice straw. The mutant 12 UV/1 produced 306.21% and 209.91% cellulase and xylanase, respectively, as compared with the original wild type strain. This mutant showed high capacity of rice straw degradation. The effectiveness of tested mutant strain and that of wild strain was compared in relation to enhancing the composting process of rice straw and animal manures mixture. The results obtained showed that the compost product of inoculated mixture with mutant strain (12 UV/1) was the best compared to the wild strain and un-inoculated mixture. Analysis of the composted materials showed that the characteristics of the produced compost were close to those of the high quality standard compost. The results obtained in the present work suggest that the combination between rice straw and animal manure could be used for enhancing the composting process of rice straw and particularly when applied with fungal decomposer accelerating the composting process.Keywords: rice straw, composting, UV mutants, Penicillium
Procedia PDF Downloads 282664 Prevalence of High Risk Human Papillomavirus in Cervical Dysplasia and Cancer Samples from Twin Cities in Pakistan
Authors: Sana Gul, Sheeba Murad, Aneela Javed
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Introduction: Human Papilloma Virus (HPV) is small DNA virus mostly infecting mucosa and cutaneous keratinocytes. So far, more than 200 Human papillomaviruses are known. HPV have been divided into high- and low-risk on the basis of their oncogenic potential. High risk HPV is considered to be the main etiological cause for cervical cancer. Objective: Current study was designed to screen the local cervical cancer patients from the twin cities of Pakistan for the occurance of high risk HPV. Methodology: A total of 67 formalin fixed paraffin-embedded samples of cervical cancer biopsies were obtained from the government hospitals in Islamabad and Rawalpindi. Cervical cancer biopsies were examined for the presence of HPV DNA. Polymerase chain reaction (PCR) was used for the amplification of a region in the HPV-L1 gene for the general detection of the Papilloma virus and for the genotype specific detection of high risk HPV 16 and 18 using the GP5/GP6 primers and genotype specific primers respectively. Results: HPV DNA was detected in 59 out of 67 samples analyzed. 30 samples showed the presence of HPV16 while 22 samples were positive for HPV 18 . HPV subtype could not be determined in 7 samples. Conclusion: Our results show a strong association between HPV infection and cervical cancer among women in twin cities of Pakistan. One way to minimize the disease burden in relation to HPV infection in Pakistani population is the use of prophylactic vaccines and routine screening. An early diagnosis of HPV infection will allow better health management to reduce the risk of developing cervical cancer.Keywords: cervical cancer, Pakistan, human papillomavirus, HPV 16
Procedia PDF Downloads 338663 Production of Camel Nanobodies against of Anti-Morphine-3-Glucuronide for the Development of a Biosensor for Detecting Illicit Drug
Authors: Shirin Jalili, Sadegh Hasannia, Hadi Shirzad, Afshin Khara
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Morphine is one of the most medicinally important analgesics and narcotics. Structurally, it is classified as an alkaloid because of the presence of nitrogen. Its structure is similar to that of codeine, thebaine, and heroin. An immunoassay to accurately discriminate between these analogous alkaloids would be highly beneficial. A key factor for such an assay is specificity with high sensitivity, which is totally dependent on the antibody employed. However, most antibodies against haptens are polyclonal serum antibodies that exhibit significant cross-reactivities with closely related compounds. The camel-derived single-chain antibody fragments (VHH) are the smallest molecules with antigen-binding capacity, possessing unique properties compared to other conventional antibodies. In this study, a library containing the VHH genes of a camel immunized with with morphine conjugated BSA following phage display technology was generated. By screening the camel-derived variable region of the heavy chain cDNA phage display library with the ability to bind the desired hapten, we obtained some nanobodies that recognize this hapten. Phage display expression of the Nbs from this library and pannings against this hapten resulted in a clear enrichment of four distinct Nb-displaying phages with specificity for morphine that could be a potential target site for the development of new strategies for the development of a biosensor for detecting illicit drug.Keywords: phage display, nanobody, Morphine-3, glucuronide, ELISA, biosensor
Procedia PDF Downloads 425662 Mitigation of Offshore Piling Noise Effects on Marine Mammals
Authors: Waled A. Dawoud, Abdelazim M. Negm, Nasser M. Saleh
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Offshore piling generates underwater sound at level high enough to cause physical damage or hearing impairment to the marine mammals. Several methods can be used to mitigate the effect of underwater noise from offshore pile driving on marine mammals which can be divided into three main approaches. The first approach is to keep the mammal out of the high-risk area by using aversive sound waves produced by acoustic mitigation devices such as playing-back of mammal's natural predator vocalization, alarm or distress sounds, and anthropogenic sound. The second approach is to reduce the amount of underwater noise from pile driving using noise mitigation techniques such as bubble curtains, isolation casing, and hydro-sound dampers. The third approach is to eliminate the overlap of underwater waves by using prolonged construction process. To investigate the effectiveness of different noise mitigation methods; a pile driven with 235 kJ rated energy diesel hammer near Jeddah Coast, Kingdom of Saudi Arabia was used. Using empirical sound exposure model based on Red Sea characteristics and limits of National Oceanic and Atmospheric Administration; it was found that the aversive sound waves should extend to 1.8 km around the pile location. Bubble curtains can reduce the behavioral disturbance area up to 28%; temporary threshold shift up to 36%; permanent threshold shift up to 50%; and physical injury up to 70%. Isolation casing can reduce the behavioral disturbance range up to 12%; temporary threshold shift up to 21%; permanent threshold shift up to 29%; and physical injury up to 46%. Hydro-sound dampers efficiency depends mainly on the used technology and it can reduce the behavioral disturbance range from 10% to 33%; temporary threshold shift from 18% to 25%; permanent threshold shift from 32% to 50%; and physical injury from 46% to 60%. To prolong the construction process, it was found that the single pile construction, use of soft start, and keep time between two successive hammer strikes more than 3 seconds are the most effective techniques.Keywords: offshore pile driving, sound propagation models, noise effects on marine mammals, Underwater noise mitigation
Procedia PDF Downloads 543661 A Preliminary Finding Regarding Nutrition Information Needs among Family Physicians in Turkey
Authors: F. Nur Baran Aksakal, Özge Dinç, H. Tanju Besler, Begüm Mutuş, Özlem Üliç Çatar, Orhan Aydoğdu, Serhat Ünal
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Healthy eating habits are associated not only with the newborn, child, and maternal health but also with longer life expectancy by acting as a protective factor against non-communicable diseases such as obesity, diabetes, cardiovascular diseases, and cancer. The role of nutrition in medical education is to provide information about the relationship between healthy nutrition and malnutrition as well as diet-related non-communicable diseases. Considering the information pollution experienced in the field of nutrition and health in the society, it is seen that more than half of the population receives information from family physicians as the closest counseling unit. However, postgraduate nutrition education programs for physicians and other health professionals who wish to improve their current knowledge of the role of nutrition communication in the prevention and management of chronic diseases are limited worldwide. However, nutrition courses are either not included in the undergraduate medical education curriculum of physicians or they are insufficient. Based on this need, the main aim of the study group was to develop a "Nutrition and Nutrition Communication Training for Physicians" program that would be conducted in cooperation with the Sabri Ülker Foundation and the Federation of Family Physicians Associations (AHEF). This program is the first online nutrition and nutrition communication information platform for physicians in Turkey. This program aims to present the concept of adequate and balanced nutrition to physicians, the importance of nutrition in diseases with scientific data, and to gain communication skills that may be necessary while transferring scientific information to the public. A needs assessment questionnaire was applied to identify pre-program training needs. A study plan was made to allow the participation of all family physicians in the population, and a complete inventory was targeted. In other words, we aimed to reach the whole source without taking a section of the population. Participation in the training is based on volunteerism. The needs assessment study is conducted using 25,102 family physicians for whom email addresses are available. The online questionnaire was sent to all the family physicians with a reminder email one week after the first one, and 1308 responded. Considering the topics determined, a training program was prepared for family physicians under eight online training titles, starting in March 2022, and conducted once every two weeks. The number of audience members present at each session was between 1217 and 1673, and a minimum of 17 and a maximum of 53 questions were received in each session. We strongly believe that to prevent individuals' health problems and to have better control over chronic diseases, the information level of physicians should be increased via these kinds of interventions, and better collaboration between family physicians and dieticians should be established.Keywords: nutrition communication, nutrition training, communication, nutrition
Procedia PDF Downloads 97660 Pilot Scale Sub-Surface Constructed Wetland: Evaluation of Performance of Bed Vegetated with Water Hyacinth in the Treatment of Domestic Sewage
Authors: Abdul-Hakeem Olatunji Abiola, A. E. Adeniran, A. O. Ajimo, A. B. Lamilisa
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Introduction: Conventional wastewater treatment technology has been found to fail in developing countries because they are expensive to construct, operate and maintain. Constructed wetlands are nowadays considered as a low-cost alternative for effective wastewater treatment, especially where suitable land can be available. This study aims to evaluate the performance of the constructed wetland vegetated with water hyacinth (Eichhornia crassipes) plant for the treatment of wastewater. Methodology: The sub-surface flow wetland used for this study was an experimental scale constructed wetland consisting of four beds A, B, C, and D. Beds A, B, and D were vegetated while bed C which was used as a control was non-vegetated. This present study presents the results from bed B vegetated with water hyacinth (Eichhornia crassipes) and control bed C which was non-vegetated. The influent of the experimental scale wetland has been pre-treated with sedimentation, screening and anaerobic chamber before feeding into the experimental scale wetland. Results: pH and conductivity level were more reduced, colour of effluent was more improved, nitrate, iron, phosphate, and chromium were more removed, and dissolved oxygen was more improved in the water hyacinth bed than the control bed. While manganese, nickel, cyanuric acid, and copper were more removed from the control bed than the water hyacinth bed. Conclusion: The performance of the experimental scale constructed wetland bed planted with water hyacinth (Eichhornia crassipes) is better than that of the control bed. It is therefore recommended that plain bed without any plant should not be encouraged.Keywords: constructed experimental scale wetland, domestic sewage, treatment, water hyacinth
Procedia PDF Downloads 132659 Binding Studies of Complexes of Anticancer Drugs with DNA and Enzymes Involved in DNA Replication Using Molecular Docking and Cell Culture Techniques
Authors: Fouzia Perveen, Rumana Qureshi
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The presently studied twelve anticancer drugs are the cytotoxic agents which inhibit the replication of DNA and activity of enzymes involved in DNA replication namely topoisomerase-II, polymerase and helicase and have shown remarkable anticancer activity in clinical trials. In this study, we performed molecular docking studies of twelve antitumor drugs against DNA and DNA enzymes in the presence and absence of ascorbic acid (AA) and developed the quantitative structure-activity relationship (QSAR) model for anticancer activity screening. A number of electronic and steric descriptors were calculated using MOE software package. QSAR was established showing a correlation of binding strength with various physicochemical descriptors. Out of these twelve, eight cytotoxic drugs were tested on Non-Small Cell Lung Cancer cell lines (H-157 and H-1299) in the absence and presence of ascorbic acid and experimental IC50 values were calculated. From the docking studies, binding constants were calculated indicating the strength of drug-DNA and drug-enzyme complex formation and it was correlated to the IC50 values (both experimental and theoretical). These results can offer useful references for directing the molecular design of DNA enzyme inhibitor with improved anticancer activity.Keywords: ascorbic acid, binding constant, cytotoxic agents, cell culture, DNA, DNA enzymes, molecular docking
Procedia PDF Downloads 424658 Hyaluronic Acid Binding to Link Domain of Stabilin-2 Receptor
Authors: Aleksandra Twarda, Dobrosława Krzemień, Grzegorz Dubin, Tad A. Holak
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Stabilin-2 belongs to the group of scavenger receptors and plays a crucial role in clearance of more than 10 ligands from the bloodstream, including hyaluronic acid, products of degradation of extracellular matrix and metabolic products. The Link domain, a defining feature of stabilin-2, has a sequence similar to Link domains in other hyaluronic acid receptors, such as CD44 or TSG-6, and is responsible for most of ligands binding. Present knowledge of signal transduction by stabilin-2, as well as ligands’ recognition and binding mechanism, is limited. Until now, no experimental structures have been solved for any segments of stabilin-2. It has recently been demonstrated that the stabilin-2 knock-out or blocking of the receptor by an antibody effectively opposes cancer metastasis by elevating the level of circulating hyaluronic acid. Moreover, loss of expression of stabilin-2 in a peri-tumourous liver correlates with increased survival. Solving of the crystal structure of stabilin-2 and elucidation of the binding mechanism of hyaluronic acid could enable the precise characterization of the interactions in the binding site. These results may allow for designing specific small-molecule inhibitors of stabilin-2 that could be used in cancer therapy. To carry out screening for crystallization of stabilin-2, we cloned constructs of the Link domain of various lengths with or without surrounding domains. The folding properties of the constructs were checked by nuclear magnetic resonance (NMR). It is planned to show the binding of hyaluronic acid to the Link domain using several biochemical methods, i.a. NMR, isothermal titration calorimetry and fluorescence polarization assay.Keywords: stabilin-2, Link domain, X-ray crystallography, NMR, hyaluronic acid, cancer
Procedia PDF Downloads 400657 Nutritional Status and Body Image Perception among Thai Adolescents
Authors: Nareemarn Neelapaichit, Sookfong Wongsathapat, Noppawan Piaseu
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Body image plays an important role in adolescents. Thai adolescents put high concern on their body image result in unsatisfied their body shapes. Therefore, inappropriate weight management methods have been used. This study examined the body image perception and the nutritional status of Thai adolescents. Body mass index screening was done on 181 nursing students of Ramathibodi School of Nursing to categorized obesity, overweight, normal weight and underweight respondents by using recommended body-mass index (BMI) cut-off points for Asian populations. Self report questionnaire on demographics and body image perception were completed. Results showed that the respondents were mainly female (93.4%) and their mean age were 19.2 years. The prevalence of obesity, overweight, normal weight and underweight of the nursing students were 5.5%, 7.2%, 55.2% and 32.0%, respectively. Of all the respondents, 57.5% correctly perceived themselves, with 37.0% overestimating and 5.5% underestimating their weight status. Of those in the obesity category, 20.0% correctly perceived themselves and 80.0% perceived themselves as overweight. For overweight category, total respondents correctly perceived themselves. Fifty two percent of the normal weight respondents perceived themselves as overweight and 2.0% perceived themselves as obesity. Of the underweight respondents, 77.6% correctly perceived themselves and 20.7% perceived themselves as normal weight. These findings show high occurrence of body image misperception among Thai adolescents. Being concerned with this situation can promote adolescents for healthy weight and practice appropriate weight management methods.Keywords: nutritional status, body image perception, Thai adolescents, body-mass index (BMI)
Procedia PDF Downloads 391656 Determination of Acid Volatile Sulfides–Simultaneously Extracted Metal Relationship and Toxicity in Contaminated Sediment Layer in Mid-Black Sea Coasts
Authors: Arife Simsek, Gulfem Bakan
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Sediment refers to the accumulation of varying amounts of sediment material in natural waters and the formation of bottom sludge. Sediments are the most important sources of pollutants as well as important future sources and carriers of pollutants. The accumulation of pollutants in sediments can cause serious environmental problems for the surrounding areas. Heavy metals (such as Cr, Cd, Al, Pb, Cu, Al, Zn) disrupt the water quality, affect the useful use of sediment, affect the ecosystem and have a toxic effect on the life of the sediment layer. This effect, which accumulates in the aquatic organisms, can enter the human body with the food chain and affect health seriously. Potential metal toxicity can be determined by comparing acid volatile sulfides (AVS) – simultaneously extracted metal (SEM) ratio in anoxic sediments to determine the effect of metals. Determination of the concentration of SEM and AVS is useful in screening sediments for potential toxicity due to the high metal concentration. In the case of SEM/AVS < 0 (anoxic sediment); in terms of AVS biomass production, its toxicity can be controlled. No toxic effects may be observed when SEM / AVS < 0. SEM / AVS > 0 (in the case of oxic sediment); metals with sensitive fraction such as Cu, As, Ag, Zn are stored. In this study, AVS and SEM measurements of sediment samples collected from five different points in the district of Tekkeköy in Samsun province were performed. The SEM - AVS ratio was greater than 0 in all samples. Therefore, it is necessary to test the toxicity against the risks that may occur in the ecosystem.Keywords: AVS-SEM, Black Sea, heavy metal, sediment, toxicity
Procedia PDF Downloads 137655 The out of Proportion - Pulmonary Hypertension in Indians with Chronic Lung Disease
Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale
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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.Keywords: COPD, pulmonary hypertension, chronic lung disease, India
Procedia PDF Downloads 356654 Avidity and IgE versus IgG and IgM in Diagnosis of Maternal Toxoplasmosis
Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik
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Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.Keywords: diagnosis, serology, seroprevalence, toxoplasmosis
Procedia PDF Downloads 151653 Evaluation of Prevalence of the Types of Thyroid Disorders Using Ultrasound and Pathology of One-Humped Camel in Iran: Camelus dromedarius
Authors: M. Yadegari
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The thyroid gland is the largest classic endocrine organ that effects many organs of the body and plays a significant role in the process of Metabolism in animals. The aim of this study was to investigate the prevalence of thyroid disorders diagnosed by ultrasound and microscopic Lesions of the thyroid during the slaughter of apparently healthy One Humped Camels (Camelus dromedarius) in Iran. Randomly, 520 male camels (With an age range of 4 to 8 years), were studied in 2012 to 2013. The Camels’ thyroid glands were evaluated by sonographic examination. In both longitudinal and transverse view and then tissue sections were provide and stained with H & E and finally examined by light microscopy. The results obtained indicated the following: hyperplastic goiter (21%), degenerative changes (12%), follicular cysts (8%), follicular atrophy (4%), nodular hyperplasia (3%), adenoma (1%), carcinoma (1%) and simple goiter colloid (1%). Ultrasound evaluation of thyroid gland in adenoma and carcinoma showed enlargement and irregular of the gland, decreased echogenicity, and the heterogeneous thyroid parenchyma. Also, in follicular cysts were observed in the enlarged gland with no echo structures of different sizes and decreased echogenicity as a local or general. In nodular hyperplasia, increase echogenicity and heterogeneous parenchymal were seen. These findings suggest the use of Ultrasound as a screening test in the diagnosis of complications of thyroid disorders. Pathology also to be used for the diagnosis of thyroid problems and other side effects.Keywords: thyroid gland, one humped camel, sonography, pathology
Procedia PDF Downloads 504652 Tunable Optoelectronic Properties of WS₂ by Local Strain Engineering and Folding
Authors: Ahmed Raza Khan
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Local-strain engineering is an exciting approach to tune the optoelectronic properties of materials and enhance the performance of devices. Two dimensional (2D) materials such as 2D transition metal dichalcogenides (TMDCs) are particularly well-suited for this purpose because they have high flexibility and can withstand high deformations before rupture. Wrinkles on thick TMDC layers have been reported to show the interesting photoluminescence enhancement due to bandgap modulation and funneling effect. However, the wrinkles in ultrathin TMDCs have not been investigated, because the wrinkles can easily fall down to form folds in these ultrathin layers of TMDCs. Here, we have achieved both wrinkle and fold nano-structures simultaneously on 1-3L WS₂ using a new fabrication technique. The comparable layer dependent reduction in surface potential is observed for both folded layers and corresponding perfect pack layers due to the dominant interlayer screening effect. The strains produced from the wrinkle nanostructures considerably vary semi conductive junction properties. Thermo-ionic modelling suggests that the strained (1.6%) wrinkles can lower the Schottky barrier height (SBH) by 20%. The photo-generated carriers would further significantly lower the SBH. These results present an important advance towards controlling the optoelectronic properties of atomically thin WS₂ using strain engineering, with important implications for practical device applications.Keywords: strain engineering, folding, WS₂, Kelvin probe force microscopy, KPFM, surface potential, photo current, layer dependence
Procedia PDF Downloads 106651 Smart Energy Consumers: An Empirical Investigation on the Intention to Adopt Innovative Consumption Behaviour
Authors: Cecilia Perri, Vincenzo Corvello
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The aim of the present study is to investigate consumers' determinants of intention toward the adoption of Smart Grid solutions and technologies. Ajzen's Theory of Planned Behaviour (TPB) model is applied and tested to explain the formation of such adoption intention. An exogenous variable, taking into account the resistance to change of individuals, was added to the basic model. The elicitation study allowed obtaining salient modal beliefs, which were used, with the support of literature, to design the questionnaire. After the screening phase, data collected from the main survey were analysed for evaluating measurement model's reliability and validity. Consistent with the theory, the results of structural equation analysis revealed that attitude, subjective norm, and perceived behavioural control positively, which affected the adoption intention. Specifically, the variable with the highest estimate loading factor was found to be the perceived behavioural control, and, the most important belief related to each construct was determined (e.g., energy saving was observed to be the most significant belief linked with attitude). Further investigation indicated that the added exogenous variable has a negative influence on intention; this finding confirmed partially the hypothesis, since this influence was indirect: such relationship was mediated by attitude. Implications and suggestions for future research are discussed.Keywords: adoption of innovation, consumers behaviour, energy management, smart grid, theory of planned behaviour
Procedia PDF Downloads 408650 Communication Barriers in Midwifery Students in the Field of Perinatal Palliative Care
Authors: Magdalena Hasplova, Katerina Ivanova
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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family
Procedia PDF Downloads 116649 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit
Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham
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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine
Procedia PDF Downloads 371648 A Multilevel Analysis of Predictors of Early Antenatal Care Visits among Women of Reproductive Age in Benin: 2017/2018 Benin Demographic and Health Survey
Authors: Ebenezer Kwesi Armah-Ansah, Kenneth Fosu Oteng, Esther Selasi Avinu, Eugene Budu, Edward Kwabena Ameyaw
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Background: Maternal mortality, particularly in Benin, is a major public health concern in Sub-Saharan Africa. To provide a positive pregnancy experience and reduce maternal morbidities, all pregnant women must get appropriate and timely prenatal support. However, many pregnant women in developing countries, including Benin, begin antenatal care late. There is a paucity of empirical literature on the prevalence and predictors of early antenatal care visits in Benin. As a result, the purpose of this study is to investigate the prevalence and predictors of early antenatal care visits among women of productive age in Benin. Methods: This is a secondary analysis of the 2017/2018 Benin Demographic and Health Survey (BDHS) data. The study involved 6,919 eligible women. Data analysis was conducted using Stata version 14.2 for Mac OS. We adopted a multilevel logistic regression to examine the predictors of early ANC visits in Benin. The results were presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and p-value <0.05 to determine the significant associations. Results: The prevalence of early ANC visits among pregnant women in Benin was 57.03% [95% CI: 55.41-58.64]. In the final multilevel logistic regression, early ANC visit was higher among women aged 30-34 [aOR=1.60, 95% CI=1.17-2.18] compared to those aged 15-19, women with primary education [aOR=1.22, 95% CI=1.06-142] compared to the non-educated women, women who were covered by health insurance [aOR=3.03, 95% CI=1.35-6.76], women without a big problem in getting the money needed for treatment [aOR=1.31, 95% CI=1.16-1.49], distance to the health facility, not a big problem [aOR=1.23, 95% CI=1.08-1.41], and women whose partners had secondary/higher education [aOR=1.35, 95% CI=1.15-1.57] compared with those who were not covered by health insurance, had big problem in getting money needed for treatment, distance to health facility is a big problem and whose partners had no education respectively. However, women who had four or more births [aOR=0.60, 95% CI=0.48-0.74] and those in Atacora Region [aOR=0.50, 95% CI=0.37-0.68] had lower odds of early ANC visit. Conclusion: This study revealed a relatively high prevalence of early ANC visits among women of reproductive age in Benin. Women's age, educational status of women and their partners, parity, health insurance coverage, distance to health facilities, and region were all associated with early ANC visits among women of reproductive in Benin. These factors ought to be taken into account when developing ANC policies and strategies in order to boost early ANC visits among women in Benin. This will significantly reduce maternal and newborn mortality and help achieve the World Health Organization’s recommendation that all pregnant women should initiate early ANC visits within the first three months of pregnancy.Keywords: antenatal care, Benin, maternal health, pregnancy, DHS, public health
Procedia PDF Downloads 65647 Physiological Regulation of Lignin-Modifying Enzymes Synthesis by Selected Basidiomycetes
Authors: Ana Tsokilauri
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The uppermost factor in the regulation of lignin-cellulose activity of decaying white rot or free rot are the substances serving as carbon and nitrogen nutrition of microorganisms and are considered as the most important factor of generative activity of white rot. The research object was Basidiomycete Fungi, peculiar and common in Georgia, and the separation of 10 of them as pure crops. The unidentified pure crops have tasted in order to be determined the potential of synthesis of lignin-degrading enzymes and the substrate of optimal lignocellulose growth. One of the most important aspects of the research conducted on Basidiomycetes was the use of specific lignocellulosic residues for selecting Fungi as a substrate of their growth. In order to increase lignocellulose with the help of substrate, crops were selected from the screening stage that showed good laccase activity. (Dusheti 1; Dusheti 10; Fshavi 5; Fshavi1; Fshavi 8; Fshavi 32; Manglisi 26; Sabaduri20; Dusheti 7; Sabaduri 1 ), Among the selected cultures, the crops with good laccase activity against the following substances, in particular: Dusheti 1- in this case, the rate of enzymatic activity on bran substrate was -105,6 u/ml, mandarin-96,4 u/ml. In case of corn - 102,9 u/ml. In case of Dusheti 7- the indicators were as follows: bananas-121,7 u/ml, mandarin-125,4 u/ml, corn - 117,1 u/ml. In the case of Sanaduri 32, the laccase activity was as follows: pomegranate- 101,2 u/ml. As a result of conducted experiments, the synthesis and activity rates of enzymes depending on plant substrates varied within a fairly wide range, which is still being under research.Keywords: Lignocellulosic substrate, Basidiomycetes, white-rot basidiomycetes, Laccase
Procedia PDF Downloads 195646 Interoception and Its Role in Connecting Empathy, Bodily Perception and Conceptual Representations: A Cross-Cultural Online Study
Authors: Fabio Marson, Revital Naor-Ziv, Patrizio Paoletti, Joseph Glicksohn, Filippo Carducci, Tal Dotan Ben-Soussan
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According to embodied cognition theories, higher-order cognitive functions and complex behaviors seems to be affected by bodily states. For example, the polyvagal theory suggests that the human autonomic nervous system evolved to support social interactions. Accordingly, integration and perception of information related to the physiological state arising from the peripherical nervous system (i.e., interoception) play a role in the regulation of social interaction by modulating emotional responses and prosocial behaviors. Moreover, recent studies showed that interoception is involved in the representations of conceptual knowledge, suggesting that the bodily information carried by the interoceptive system provides a perceptual basis for the embodiment of abstract concepts, especially those related to social and emotional domains. However, to the best of our knowledge, no studies explored the relationship between interoception, prosocial behaviors, and conceptual representations. Considering the privileged position of interoception in mediating higher-order cognition and social interaction, we designed a cross-cultural study to explore the relationship between interoception, the sensitivity of bodily functions, and empathy. We recruited Italian, English, and Hebrew participants, and we asked them to fill in a questionnaire about empathy (Empathy Quotient), a questionnaire about bodily perception (Body Perception Questionnaire), and to rate different concrete and abstract concepts for the extent such concepts can be experienced through vision, hearing, taste, smell, touch, and interoception. We observed that in all languages, interoception ratings for abstract concepts were greater than for concrete concepts. Importantly, interoception ratings for abstract concepts were positively correlated with empathy and sensitivity of bodily functions. Our results suggest that participants with higher empathy and sensitivity of bodily functions show also a greater embodiment of abstract concepts in interoception, providing further evidence for the importance of the interoceptive system in regulating prosocial behaviors and integrating conceptual representations.Keywords: conceptual representations, embodiment, empathy, empathy quotient, interoception, prosocial behaviors
Procedia PDF Downloads 164645 Electromagnetic Radiation Generation by Two-Color Sinusoidal Laser Pulses Propagating in Plasma
Authors: Nirmal Kumar Verma, Pallavi Jha
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Generation of the electromagnetic radiation oscillating at the frequencies in the terahertz range by propagation of two-color laser pulses in plasma is an active area of research due to its potential applications in various areas, including security screening, material characterization, and spectroscopic techniques. Due to nonionizing nature and the ability to penetrate several millimeters, THz radiation is suitable for diagnosis of cancerous cells. Traditional THz emitters like optically active crystals, when irradiated with high power laser radiation, are subject to material breakdown and hence low conversion efficiencies. This problem is not encountered in laser-plasma based THz radiation sources. The present paper is devoted to the study of the enhanced electromagnetic radiation generation by propagation of two-color, linearly polarized laser pulses through the magnetized plasma. The two lasers pulse orthogonally polarized are co-propagating along the same direction. The direction of the external magnetic field is such that one of the two laser pulses propagates in the ordinary mode, while the other pulse propagates in the extraordinary mode through the homogeneous plasma. A transverse electromagnetic wave with frequency in the THz range is generated due to the presence of the static magnetic field. It is observed that larger amplitude terahertz can be generated by mixing of ordinary and extraordinary modes of two-color laser pulses as compared with a single laser pulse propagating in the extraordinary mode.Keywords: two-color laser pulses, electromagnetic radiation, magnetized plasma, ordinary and extraordinary modes
Procedia PDF Downloads 284644 Green Synthesis and Characterization of Zinc Oxide Nanoparticles Using Neem (Azadiractha Indica) Leaf Extract and Investigate Its Antibacterial Activities
Authors: Elmineh Tsegahun Gedif
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Zinc oxide nanoparticles (ZnO NPs) have attracted huge attention due to catalytic, optical, photonic, and antibacterial activity. Zinc oxide nanoparticles were successfully synthesized via a fast, non-toxic, cost-effective, and eco-friendly method by biologically reducing Zn(NO3)2.6H2O solution with Neem (Azadirachta indica) leaf extract under optimum conditions (pH = 9). The presence of active flavonoids, phenolic groups, alkaloids, terpenoids, and tannins, which were in the biomass of the Neem leaf extract before and after reduction, was identified using qualitative screening methods (observing the color changes) and FT-IR Spectroscopy. The formation of ZnO NPs was visually indicated by the color changes from colorless to light yellow color. Biosynthesized nanoparticles were also characterized by UV-visible, FT-IR, and XRD spectroscopies. The reduction process was simple and convenient to handle and was monitored by UV-visible spectroscopy that showed surface plasmon resonance (SPR) of the ZnO NPs at 321 nm. This result clearly revealed the formation of ZnO NPs. X-ray diffraction was used to investigate the crystal structure. The average particle size of ZnO powder and around 20 nm using the line width of the plane, and the refraction peak using Scherrer’s equation. The synthesized zinc oxide nanoparticles were evaluated for antimicrobial activities against Gram-positive and Gram-negative bacteria. Zinc nanoparticles exhibited the maximum zone of inhibition against Escherichia coli (15 mm), while the least activity was seen against Staphylococcus aureus.Keywords: antimicrobial activity, azadirachta indica, green synthesis, ZnO NPs
Procedia PDF Downloads 110643 Examination of Predictive Factors of Depression among Asian American Adolescents: A Narrative Review
Authors: Annisa Siu, Ping Zou
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Background: Existent literature addressing Asian American children and adolescents reveals that this population is experiencing rates of depression comparable to those of European American and other ethnic minority youths. Within the last decade, increased attention has been given to Asian American adolescent mental health. Methods: 44 articles were extracted from Pubmed, PsycINFO, EMBASE, and Proquest CINAHL. Data were subject to thematic analyses and categorized into factors under individual, familial, and community levels. Results: Of all the individual factors, age and gender were the most supported in their relationship with depressive symptoms. Likewise, living situations, parent-child relations, peer relations, and broader environmental factors were strongly evidenced. The remaining psychosocial factors faced contrary evidence or were insubstantially addressed in the empirical literature. Discussion: The identified psychosocial factors within this study offer a starting point for future research to examine what factors should be included in formal or informal methods of screening/consultations. Clinicians should aim to understand the cultural influences specific to Asian American adolescents, particularly the central role that family relations may have on their depressive symptoms. Conclusion: Low awareness of culturally linked expressions of psychological distress can lead to misdiagnosis or under-diagnosis of depression in Asian American youth. Further evidence is needed to clarify the relationship of psychosocial factors linked to Asian American adolescent depressive symptoms.Keywords: adolescent, Asian American, depression, psychosocial factors
Procedia PDF Downloads 121642 Detection of Atrial Fibrillation Using Wearables via Attentional Two-Stream Heterogeneous Networks
Authors: Huawei Bai, Jianguo Yao, Fellow, IEEE
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Atrial fibrillation (AF) is the most common form of heart arrhythmia and is closely associated with mortality and morbidity in heart failure, stroke, and coronary artery disease. The development of single spot optical sensors enables widespread photoplethysmography (PPG) screening, especially for AF, since it represents a more convenient and noninvasive approach. To our knowledge, most existing studies based on public and unbalanced datasets can barely handle the multiple noises sources in the real world and, also, lack interpretability. In this paper, we construct a large- scale PPG dataset using measurements collected from PPG wrist- watch devices worn by volunteers and propose an attention-based two-stream heterogeneous neural network (TSHNN). The first stream is a hybrid neural network consisting of a three-layer one-dimensional convolutional neural network (1D-CNN) and two-layer attention- based bidirectional long short-term memory (Bi-LSTM) network to learn representations from temporally sampled signals. The second stream extracts latent representations from the PPG time-frequency spectrogram using a five-layer CNN. The outputs from both streams are fed into a fusion layer for the outcome. Visualization of the attention weights learned demonstrates the effectiveness of the attention mechanism against noise. The experimental results show that the TSHNN outperforms all the competitive baseline approaches and with 98.09% accuracy, achieves state-of-the-art performance.Keywords: PPG wearables, atrial fibrillation, feature fusion, attention mechanism, hyber network
Procedia PDF Downloads 120641 A Case Study of Spontaneous Heterotopic Pregnancy with Subsequent Ruptured Ectopic Pregnancy
Authors: M. Elder, L. Beech, A. Mackie
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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy
Procedia PDF Downloads 138