Search results for: diffuse coronary artery disease

Authors: Kidane Workelul, Yohans Tekle, Guesh Negash, Haftay Abraha, Nigus Abebe Shumuye, Yisehak Tsegaye Redda

Abstract:

Bovine papillomatosis (wart) is one of the economically important bovine skin diseases worldwide, caused by a group of viruses named papillomaviruses (PVs). However, it has often been misdiagnosed as other skin diseases and remained untreated. In order to determine the status of the diseases, twenty-two farms were visited, and fourteen infected cattle with cutaneous papillomatosis were identified from a total of 235. Papilloma biopsies were taken for molecular and histopathological characterization, the therapeutic trial of an autogenous vaccine was evaluated on infected animals. The overall status of bovine papillomatosis in this study was calculated as 5.96% (14/235). The disease was found to be statistically significant in the age groups less than two years (X² = 26.69, P = 0.0001). The more prominent histologically characterized lesions in the sampled tissue were identified as squamous papilloma and fibro-papilloma. The Polymerase Chain Reaction (PCR) based identification revealed that all the clinically and histo-pathologically characterized papillomatosis cases were found to be infected with Bovine Papilloma Virus1(BPV1), indicating that BPV1 was the most common and sole causative agent of the diseases in the study area. In immunizing active bovine papillomatosis, an autogenous vaccine therapeutic trial demonstrated excellent results, with practically full recovery and no recurrence of the infection. Hence, it is concluded that bovine papillomatosis is an economically important disease of young age group cattle as well as a treatable disease. So, the production of marketable autogenous vaccines against bovine papillomatosis should be started and given at an early stage.

Keywords: autogenous vaccine, bovine papillomatosis, bovine papilloma virus1 clinical-pathology, polymerase chine reaction, wart

Procedia PDF Downloads 80

Authors: Prince S. Campbell, Janine B. Adams, Melusi Thwala, Opeoluwa Oyedele, Paula E. Melariri

Abstract:

Schistosomiasis, often known as bilharzia, is a parasitic water-borne disease caused by trematode flatworms of the genus Schistosoma. Schistosomiasis infection and prevention have been found to be influenced by a range of socio-cultural risk factors, including human characteristics (e.g., gender, age, education, knowledge, attitude, and practices), as well as environmental and economic elements. Lack of awareness of the disease may also contribute to an individual's tendency to participate in behaviours or activities that heighten their susceptibility to infection. The current study assessed the community knowledge, attitude and practices (KAP) on schistosomiasis and implemented an educational intervention following pre-test interviews. A cross-sectional quasi-experimental research design was used in this quantitative study. Pre- and post-intervention interview format surveys were conducted using a structured questionnaire, targeting individuals aged 18–65 years residing within 5 km of select water bodies. The questionnaire contained 54 close-ended questions about schistosomiasis causes, transmission, and clinical symptoms and the participants were interviewed face-to-face in their homes. Data was captured on Question Pro and analyzed using Microsoft Office Excel 365 (2019) and R (version 4.3.1) software. Overall, 380 individuals completed the pre and post-intervention assessments; 194 and 185 were males (51.1%) and females (48.7%), respectively. A notable 91.3% of participants did not know about schistosomiasis in the pre-intervention phase; however, the mean post-intervention test score (9.4 ± 1.4) for knowledge among participants was higher than the pre-intervention test score (2.2 ± 2.1) indicating a good and improved knowledge of schistosomiasis among the participants. Furthermore, the paired samples t-test results demonstrated that the increase in knowledge levels was statistically significant (p<0.001). Also, the post-intervention improvement of both practice (p<0.001) and attitude (p<0.001) levels was statistically significant. A positive correlation (r=0.23, p<0.001) was found between knowledge and attitude in the pre-intervention stage. Knowledgeable participants had a more positive attitude towards obtaining medical assistance and disease prevention. Moreover, attitudes and practices correlated negatively (r=-0.13, p=0.013) post-intervention; hence, those with positive attitudes did not engage in risky water-related practices, which was the desired outcome. The educational intervention had a favourable impact on the KAP of the study population as the majority were able to recall the disease aetiology, symptoms, transmission pattern, and preventative measures three months post-intervention. Nevertheless, previous research has suggested that participants were unable to recall information about the disease following the intervention. Consequently, research should prioritize behavioural modification strategies that may result in a more persistent outcome in terms of the participants' knowledge, which could ultimately contribute to the development of long-term positive attitudes and practices.

Keywords: educational intervention, knowledge, attitudes and practices, schistosomiasis

Procedia PDF Downloads 18

Authors: Muhammad Zafarullah Khan, Khalid Nawab, Shahid Ali, Mubashir Habib, Shakirullah Khan, Sajjad Ahmad, Javid Ullah, Ikramul Haq

Abstract:

Professionally competent Agriculture Officers (AOs) can play an important role in the development of agriculture in the country. This study was conducted in North West Frontier Province (NWFP) (Pakistan) to assess professional competencies of Agriculture Officers (AOs) in January 2007. Data were collected from all (112) AOs through a mailed questionnaire. The study examines existing level of professional competencies of AOs and the required level of possessed competencies needed by them for their job performance in the areas of participatory extension methodologies. Both the possessed and required levels of competencies were scaled from 1-5 on Liker scale, 1 being very low and 5 being very high. . The study revealed a numerical difference between possessed and required levels regarding the professional competencies of the participatory extension methodology. It was also observed that higher levels of job experience increase the professional competencies in participatory extension methodology. It is recommended that periodic training and refresher courses are arranged for AOs so that their learning may become more practicable to diffuse agricultural innovations among members of participatory learning groups and convey modern technologies to the end users.

Keywords: professional competency, agriculture officers, assessment and participatory extension methodology, participatory extension

Procedia PDF Downloads 340

Authors: Surabhi Gautam, Uma Kumar, Rima Dada

Abstract:

A sustained acute-phase response in Rheumatoid Arthritis (RA) is associated with increased joint damage and inflammation leading to progressive disability. It is induced continuously by consecutive stimuli of proinflammatory cytokines, following a wide range of pathophysiological reactions, leading to increased synthesis of acute phase proteins like C - reactive protein (CRP) and dysregulation in levels of immunomodulatory soluble Human Leukocyte Antigen-G (HLA-G) molecule. This study was designed to explore the effect of yoga and meditation based lifestyle intervention (YMLI) on inflammatory markers in RA patients. Blood samples of 50 patients were collected at baseline (day 0) and after 30 days of YMLI. Patients underwent a pretested YMLI under the supervision of a certified yoga instructor for 30 days including different Asanas (physical postures), Pranayama (breathing exercises), and Dhayna (meditation). Levels of CRP, IL-6, IL-17A, soluble HLA-G and erythrocyte sedimentation rate (ESR) were measured at day 0 and 30 interval. Parameters of disease activity, disability quotient, pain acuity and quality of life were also assessed by disease activity score (DAS28), health assessment questionnaire (HAQ), visual analogue scale (VAS), and World Health Organization Quality of Life (WHOQOL-BREF) respectively. There was reduction in mean levels of CRP (p < 0.05), IL-6 (interleukin-6) (p < 0.05), IL-17A (interleukin-17A) (p < 0.05) and ESR (p < 0.05) and elevation in soluble HLA-G (p < 0.05) at 30 days compared to baseline level (day 0). There was reduction seen in DAS28-ESR (p < 0.05), VAS (p < 0.05) and HAQ (p < 0.05) after 30 days with respect to the base line levels (day 0) and significant increase in WHOQOL-BREF scale (p < 0.05) in all 4 domains of physical health, psychological health, social relationships, and environmental health. The present study has demonstrated that yoga practices are associated with regression of inflammatory processes by reducing inflammatory parameters and regulating the levels of soluble HLA-G significantly in active RA patients. Short term YMLI has significantly improved pain perception, disability quotient, disease activity and quality of life. Thus this simple life style intervention can reduce disease severity and dose of drugs used in the treatment of RA.

Keywords: inflammation, quality of life, rheumatoid arthritis, yoga and meditation

Procedia PDF Downloads 167

Authors: Wajad Nazeer, Saghir Ahmad, Khalid Mahmood, Altaf Hussain, Abid Mahmood, Baoliang Zhou

Abstract:

MNH-886(Bt.) is a upland cotton cultivar (Gossypium hirsutum L.) developed through hybridization of three parents [(FH-207×MNH-770)×Bollgard-1] at Cotton Research Station Multan, Pakistan. It is resistant to CLCuVD with 16.25 % disease incidence (60 DAS, March sowing) whereas moderately susceptible to CLCuVD when planted in June with disease incidence 34 % (60 DAS). This disease reaction was lowest among 25 cotton advanced lines/varieties tested at hot spots of CLCuVD. Its performance was tested during 2009 to 2012 in various indigenous, provincial, and national varietal trials in comparison with the commercial variety IR-3701 and AA-802 & CIM-496. In PCCT trial during 2009-10; 2011-12, MNH-886 surpassed all the existing Bt. strains along with commercial varieties across the Punjab province with seed cotton yield production 2658 kg ha-1 and 2848 kg ha-1 which was 81.31 and 13% higher than checks, respectively. In National Coordinated Bt. Trial, MNH-886(Bt.) produced 3347 kg ha-1 seed cotton at CCRI, Multan; the hot spot of CLCuVD, in comparison to IR-3701 which gave 2556 kg ha-1. It possesses higher lint percentage (41.01%), along with the most desirable fibre traits (staple length 28.210mm, micronaire value 4.95 µg inch-1 and fibre strength 99.5 tppsi, and uniformity ratio 82.0%). The quantification of toxicity level of crystal protein was found positive for Cry1Ab/Ac protein with toxicity level 2.76µg g-1 and Mon 531 event was confirmed. Having tremendous yield potential, good fibre traits, and great tolerance to CLCuVD we can recommended this variety for cultivation in CLCuVD hotspots of Pakistan.

Keywords: cotton, cultivar, cotton leaf curl virus, CLCuVD hit districts

Procedia PDF Downloads 318

Authors: Yunusa Aliyu Hadejia

Abstract:

Cholera is a gastrointestinal disease caused by a bacterium called Vibrio Cholerae which spread as a result of eating food or drinking water contaminated with feaces from an infected person. In this work we proposed and analyzed the impact of isolating infected people and give them therapeutic treatment, the specific objectives of the research was to formulate a mathematical model of cholera transmission incorporating treatment class, to make analysis on stability of equilibrium points of the model, positivity and boundedness was shown to ensure that the model has a biological meaning, the basic reproduction number was derived by next generation matrix approach. The result of stability analysis show that the Disease free equilibrium was both locally and globally asymptotically stable when R_0< 1 while endemic equilibrium has locally asymptotically stable when R_0> 1. Sensitivity analysis was perform to determine the contribution of each parameter to the basic reproduction number. Numerical simulation was carried out to show the impact of the model parameters using MAT Lab Software.

Keywords: mathematical model, treatment, stability, sensitivity

Procedia PDF Downloads 102

Authors: Anamika A. Sharma, Arezou Ahmadi R. A., Narendra B. Parihar, Manjusha Sajith

Abstract:

Introduction: Hemodialysis is the most effective therapeutic technique for patient with ESRD second to renal transplantation. However it is a lifelong therapy which requires frequent hospital, or dialysis centers visits mainly twice and thrice weekly, thus considerably changes the normal way of patient’s living. So this study aimed to Assess Health-Related Quality of life in End-Stage Renal Disease (ESRD) Undergoing Twice and Thrice weekly Hemodialysis. Method: A prospective observational, cross-sectional study was carried out from September 2016 to April 2017 in end-stage renal disease patients undergoing hemodialysis. Socio-demographic and clinical details of patients were obtained from the medical records. WHOQOL-BREF questionnaire was used to Access Health-Related Quality Of Life. Quality of Life scores of Twice weekly and Thrice weekly hemodialysis was analyzed by Kruskal Wallis Test. Results: Majority of respondents were male (72.55%), married (89.31%), employed (58.02%), belong to middle class (71.00%) and resides in rural area (58.78%). The mean ages in the patient undergoing twice weekly and thrice weekly hemodialysis were 51.89 ± 15.64 years and 51.33 ± 15.70 years respectively. Average Quality of Life scores observed in twice weekly and thrice weekly hemodialysis was 52.07 ± 13.30 (p=0.0037) and 52.87 ± 13.47 (p=0.0004) respectively. The hemoglobin of thrice weekly dialysis patients (10.28 gm/dL) was high as compared to twice weekly dialysis (9.23 gm/dL). Patients undergoing thrice weekly dialysis had improved serum urea, serum creatinine values (95.85 mg/dL, 8.32 mg/dL) as compared to twice weekly hemodialysis ( 104.94 mg/dL, 8.68 mg/dL). Conclusion: Our study concluded that there was no significant difference between overall Health-Related Quality Of Life in twice weekly and thrice weekly hemodialysis. Frequent hemodialysis was associated with improved control of hypertension, serum urea, serum creatinine levels.

Keywords: end stage renal disease, health related quality of life, twice weekly hemodialysis, thrice weekly hemodialysis

Procedia PDF Downloads 180

Authors: Edward Poluyi, Eghosa Morgan, Charles Poluyi, Chibuikem Ikwuegbuenyi, Grace Imaguezegie

Abstract:

Background: Current epidemiological studies have examined the associations between moderate and severe traumatic brain injury (TBI) and their risks of developing neurodegenerative diseases. Concussion, also known as mild TBI (mTBI), is however quite distinct from moderate or severe TBIs. Only few studies in this burgeoning area have examined concussion—especially repetitive episodes—and neurodegenerative diseases. Thus, no definite relationship has been established between them. Objectives : This review will discuss the available literature linking concussion and amyotrophic lateral sclerosis (ALS) and Alzheimer’s disease (AD). Materials and Methods: Given the complexity of this subject, a realistic review methodology was selected which includes clarifying the scope and developing a theoretical framework, developing a search strategy, selection and appraisal, data extraction, and synthesis. A detailed literature matrix was set out in order to get relevant and recent findings on this topic. Results: Presently, there is no objective clinical test for the diagnosis of concussion because the features are less obvious on physical examination. Absence of an objective test in diagnosing concussion sometimes leads to skepticism when confirming the presence or absence of concussion. Intriguingly, several possible explanations have been proposed in the pathological mechanisms that lead to the development of some neurodegenerative disorders (such as ALS and AD) and concussion but the two major events are deposition of tau proteins (abnormal microtubule proteins) and neuroinflammation, which ranges from glutamate excitotoxicity pathways and inflammatory pathways (which leads to a rise in the metabolic demands of microglia cells and neurons), to mitochondrial function via the oxidative pathways.

Keywords: amyotrophic lateral sclerosis, Alzheimer's disease, mild traumatic brain injury, neurodegeneration

Procedia PDF Downloads 89

Authors: Josselyn Mata Calidonio, Arianna I. Maddox, Kimberly Hamad-Schifferli

Abstract:

Rapid diagnostics are critical infectious disease tools that are designed to detect a known biomarker using antibodies specific to that biomarker. However, a way to detect unknown viruses has not yet been achieved in a paper test format. We describe here a route to make an adaptable paper immunoassay that can detect an unknown biomarker, demonstrating it on SARS-CoV-2 variants. The immunoassay repurposes cross-reactive antibodies raised against the alpha variant. Gold nanoparticles of two different colors conjugated to two different antibodies create a colorimetric signal, and machine learning of the resulting colorimetric pattern is used to train the assay to discriminate between variants of alpha and Omicron BA.5. By using principal component analysis, the colorimetric test patterns can pick up and discriminate an unknown that it has not encountered before, Omicron BA.1. The test has an accuracy of 100% and a potential calculated discriminatory power of 900. We show that it can be used adaptively and that it can be used to pick up emerging variants without the need to raise new antibodies.

Keywords: adaptive immunoassay, detecting unknown viruses, gold nanoparticles, paper immunoassay, repurposing antibodies

Procedia PDF Downloads 114

Authors: Radia Bagtache, Karima Boudjedien, Ahmed Malek Djaballah, Mohamed Trari

Abstract:

The compounds with a spinel structure have received special attention because of their numerous applications in electronics, magnetism, catalysis, electrocatalysis, photocatalysis, etc. Among these oxides, CuCo₂O₄ was selected because of its optimal band gap, very close to the ideal value for solar devices, its low cost, and a potential candidate in the field of energy storage. Herein, we reported the junction Ag/CuCo₂O₄ (5/95 % wt.) prepared by co-precipitation, characterized physically and photo electrochemically. Moreover, its performance was evaluated for the oxidation of methyl orange (MO) under solar light. The X-ray diffraction exhibited narrow peaks ascribed to the spinel CuCo₂O₄ and Ag. The SEM analysis displayed grains with regular shapes. The band gap of CuCo₂O₄ (1.38 eV) was deducted from the diffuse reflectance, and this value decreased down to 1.15 eV due to the synergy effect in the junction. The current-potential (J-E) curve plotted in Na₂SO₄ electrolyte showed a medium hysteresis, characteristic of good chemical stability. The capacitance-2 – potential (C⁻² – E) graph displayed that the spinel behaves as a p-type semiconductor, a property supported by chrono-amperometry. The conduction band, located at 4.05 eV (-0.94 VNHE), was made up of Co³⁺: 3d orbital. The result showed a total discoloration of MO after 2 h of illumination under solar light.

Keywords: junction Ag/CuCo₂O₄, semiconductor, environment, sunlight, characterization, depollution

Procedia PDF Downloads 70

Authors: Maxence Queyrel, Edi Prifti, Alexandre Templier, Jean-Daniel Zucker

Abstract:

Analysis of the human microbiome using metagenomic sequencing data has demonstrated high ability in discriminating various human diseases. Raw metagenomic sequencing data require multiple complex and computationally heavy bioinformatics steps prior to data analysis. Such data contain millions of short sequences read from the fragmented DNA sequences and stored as fastq files. Conventional processing pipelines consist in multiple steps including quality control, filtering, alignment of sequences against genomic catalogs (genes, species, taxonomic levels, functional pathways, etc.). These pipelines are complex to use, time consuming and rely on a large number of parameters that often provide variability and impact the estimation of the microbiome elements. Training Deep Neural Networks directly from raw sequencing data is a promising approach to bypass some of the challenges associated with mainstream bioinformatics pipelines. Most of these methods use the concept of word and sentence embeddings that create a meaningful and numerical representation of DNA sequences, while extracting features and reducing the dimensionality of the data. In this paper we present an end-to-end approach that classifies patients into disease groups directly from raw metagenomic reads: metagenome2vec. This approach is composed of four steps (i) generating a vocabulary of k-mers and learning their numerical embeddings; (ii) learning DNA sequence (read) embeddings; (iii) identifying the genome from which the sequence is most likely to come and (iv) training a multiple instance learning classifier which predicts the phenotype based on the vector representation of the raw data. An attention mechanism is applied in the network so that the model can be interpreted, assigning a weight to the influence of the prediction for each genome. Using two public real-life data-sets as well a simulated one, we demonstrated that this original approach reaches high performance, comparable with the state-of-the-art methods applied directly on processed data though mainstream bioinformatics workflows. These results are encouraging for this proof of concept work. We believe that with further dedication, the DNN models have the potential to surpass mainstream bioinformatics workflows in disease classification tasks.

Keywords: deep learning, disease prediction, end-to-end machine learning, metagenomics, multiple instance learning, precision medicine

Procedia PDF Downloads 125

Authors: Tekle Olbamo, Tegegn Tesfaye, Dikaso Unbushe, Belete Jorga

Abstract:

Bovine trypanosomosis is a haemoprotozoan parasitic disease, mostly transmitted by the tsetse fly (Glossina species) and poses significant losses to the livestock industry in pastoral and agro-pastoral areas. Therefore, the current study was aimed to determine the prevalence of bovine trypanosomosis and its vectorial density in some selected tsetse suppression and non-tsetse suppression areas of South Omo Zonefrom December 2018- November 2019. Dark phase contrast buffy coat, hematocrit techniques, and thin blood smear method were used for determination of prevalence and packed cell volume of trypanosomosis infection, respectively. For entomological investigation, 96 NGU traps were deployed (64 traps in tsetse suppression areas, 32 traps in tsetse non-suppression areas) in vector breeding areas. The overall prevalence of bovine trypanosomosis was 11.05% (142/1284), and overall seasonal prevalence of disease was 14.33% (92/642) and 7.78% (50/642) for dry and wet seasons, respectively. There was a statistically significant difference (P <0.05) in disease prevalence between the two seasons. Trypanosomacongolensewas the dominant parasite species; 80% and 71.64%, followed by Trypanosomavivax. Overall mean packed cell volume indicated parasitaemic animals (23.57±3.13) had significantly lower PCV than aparasitaemic animals (27.80±4.95), and animals examined during dry season (26.22±4.37) had lower mean PCV than animals examined during wet season with the significant association. Entomological study result revealed a total of 2.64 F/T/D and 2.03 F/T/D respectively from tsetse suppression areas and tsetse non-suppression areas during dry season and 0.42 F/T/D and 0.56 F/T/D during the wet season. Glossinapallidipes was the only cyclical vectors collected and identified from current study areas along with numerous mechanical vectors of genus Tabanus, Stomoxys, and Haematopota. Therefore integrated and safe control and prevention effort should be engaged to uphold cattle production and productivity in the area.

Keywords: bovine trypanosomiasis, South Omo, tsetse fly density, epidemiological study

Procedia PDF Downloads 163

Authors: Vivek Verma, Sanjeev Kumar

Abstract:

This study presents a novel quantum image encryption algorithm, using a 3D chaotic map and controlled qubit-level scrambling operations. The newly proposed 3D-BNM chaotic map effectively reduces the degradation of chaotic dynamics resulting from the finite word length effect. It facilitates the generation of highly unpredictable random sequences and enhances chaotic performance. The system’s efficacy is additionally enhanced by the inclusion of a SHA-256 hash function. Initially, classical plain images are converted into their quantum equivalents using the Novel Enhanced Quantum Representation (NEQR) model. The Generalized Quantum Arnold Transformation (GQAT) is then applied to disrupt the coordinate information of the quantum image. Subsequently, to diffuse the pixel values of the scrambled image, XOR operations are performed using pseudorandom sequences generated by the 3D-BNM chaotic map. Furthermore, to enhance the randomness and reduce the correlation among the pixels in the resulting cipher image, a controlled qubit-level scrambling operation is employed. The encryption process utilizes fundamental quantum gates such as C-NOT and CCNOT. Both theoretical and numerical simulations validate the effectiveness of the proposed algorithm against various statistical and differential attacks. Moreover, the proposed encryption algorithm operates with low computational complexity.

Keywords: 3D Chaotic map, SHA-256, quantum image encryption, Qubit level scrambling, NEQR

Procedia PDF Downloads 10

Authors: Nuray Güy, Mahmut Özacar

Abstract:

In the past few decades, considerable attention has been devoted to the photocatalysts for the photocatalytic degradation of environmental pollutants. Many novel nanostructured photocatalysts for wastewater treatment have been investigated, such as TiO2 and, CdS, ZnO and silver halides (AgX, X = Cl, Br, I). The silver halides are photosensitive materials which can absorb photons in the visible region to produce electron–hole pairs. Silver halides are expensive that restricts their applications in large-scale photocatalytic processes. Tannin contains hydroxyl functional groups, it was employed as a modifier to improve the surface properties and adsorption capacity of the activated carbon towards the metal cations uptake. In this work, we designed a new structure of magnetically separable photocatalyst that combines AgCl/ZnO nanoparticles with Fe3O4 nanoparticles deposited on tannin, which was denoted as (AgI/ZnO)-Fe3O4/Tannin. The as-prepared products are characterized by X-ray diffraction (XRD), field emission scanning electron microscope (FESEM), Fourier transform infrared (FTIR), diffuse reflectance spectra (DRS) and vibrating sample magnetometer (VSM). The photocatalyst exhibited high activity degrading a textile dye under visible light irradiation. Moreover, the excellent magnetic property gives a more convenient way to recycle the photocatalysts.

Keywords: AgI/ZnO-Fe3O4/Tannin, visible light, magnetically separable, photocatalyst

Procedia PDF Downloads 217

Authors: Benjamin Aina Peter, Amos Wale Ogunsola

Abstract:

In this paper, a mathematical model of malaria transmission was presented with the effect of seasonal shift, due to global fluctuation in temperature, on the increase of conveyor of the infectious disease, which probably alters the region transmission potential of malaria. A deterministic compartmental model was proposed and analyzed qualitatively. Both qualitative and quantitative approaches of the model were considered. The next-generation matrix is employed to determine the basic reproduction number of the model. Equilibrium points of the model were determined and analyzed. The numerical simulation is carried out using Excel Micro Software to validate and support the qualitative results. From the analysis of the result, the optimal temperature for the transmission of malaria is between and . The result also shows that an increase in temperature due to seasonal shift gives rise to the development of parasites which consequently leads to an increase in the widespread of malaria transmission in Kampala. It is also seen from the results that an increase in temperature leads to an increase in the number of infectious human hosts and mosquitoes.

Keywords: seasonal variation, indoor residual spray, efficacy of spray, temperature-dependent model

Procedia PDF Downloads 169

Authors: Ying-Yi Laio, Yea-Ru Yang, Yih-Ru Wu, Ray-Yau Wang

Abstract:

Background: Virtual reality (VR) systems are proved to increase motor performance in stroke and elderly. However, the effects have not been established in patients with Parkinson’s disease (PD). Purpose: To examine the effects of VR based training in improving muscle strength, sensory integration ability and walking abilities in patients with PD by a randomized controlled trial. Method: Thirty six participants with diagnosis of PD were randomly assigned to one of the three groups (n=12 for each group). Participants received VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group received no structured exercise program but fall-prevention education. Outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment (FGA). All outcomes were assessed at baseline, after training and at 1-month follow-up. Results: Both VRWii and TE groups showed more improvement in level walking velocity, stride length, FGA, muscle strength and vestibular system integration than control group after training and at 1-month follow-up. The VRWii training, but not the TE training, resulted in more improvement in visual system integration than the control. Conclusions: VRWii training is as beneficial as traditional exercise in improving walking abilities, sensory integration ability and muscle strength in patients with PD, and such improvements persisted at least for 1 month. The VRWii training is then suggested to be implemented in patients with PD.

Keywords: virtual reality, walking, sensory integration, muscle strength, Parkinson’s disease

Procedia PDF Downloads 329

Authors: S. S. Patil, B. U. Janugade, S. V. Patil

Abstract:

Pulsatile systems are gaining a lot of interest as they deliver the drug at the right site of action at the right time and in the right amount, thus providing spatial and temporal delivery thus increasing patient compliance. These systems are designed according to the circadian rhythm of the body. Chronotherapeutics is the discipline concerned with the delivery of drugs according to inherent activities of a disease over a certain period of time. It is becoming increasingly more evident that the specific time that patients take their medication may be even more significant than was recognized in the past. The tradition of prescribing medication at evenly spaced time intervals throughout the day, in an attempt to maintain constant drug levels throughout a 24-hour period, may be changing as researcher’s report that some medications may work better if their administration is coordinated with day-night patterns and biological rhythms. The potential benefits of chronotherapeutics have been demonstrated in the management of a number of diseases. In particular, there is a great deal of interest in how chronotherapy can particularly benefit patients suffering from allergic rhinitis, rheumatoid arthritis and related disorders, asthma, cancer, cardiovascular diseases, and peptic ulcer disease.

Keywords: pulsatile drug delivery, chronotherapeutics, circadian rhythm, asthma, chronobiology

Procedia PDF Downloads 365

Authors: Ilyasu G., Ogoina D., Otu AA, Muhammed FD, Ebenso B., Otokpa D., Rotifa S., Tuduo-Wisdom O., Habib AG

Abstract:

Background: The 2014 Ebola Virus Disease (EVD) outbreak was characterized by fear, misconceptions and irrational behaviors. We conducted a knowledge attitude and practice survey of EVD in Nigeria to inform the institution of effective control measures. Methods: Between July 30th and September 30th 2014, a cross-sectional study on knowledge, attitude and practice (KAP) of Ebola Virus Disease (EVD) was undertaken among adults of the general population and healthcare workers (HCW) in three states of Nigeria, including Kano, Cross River and Bayelsa states. Demographic information and data on KAP were obtained using a self-administered standardized questionnaire. The percentage KAP scores were categorized as good and poor. Independent predictors of good knowledge of EVD were ascertained using a binary logistic regression model. Results: Out of 1035 study participants with a median age of 32 years, 648 (62.6%) were males, 846 (81.7%) had tertiary education and 441 (42.6%) were HCW. There were 218, 239 and 578 respondents from Bayelsa, Cross Rivers, and Kano states, respectively. The overall median percentage KAP scores and interquartile ranges (IQR) were 79.46% (15.07%), 95.0% (33.33%), and 49.95% (37.50%), respectively. Out of the 1035 respondents, 470 (45.4%), 544(52.56%), and 252 (24.35%) had good KAP of EVD defined using 80%, 90%, and 70% score cut-offs, respectively. Independent predictors of good knowledge of EVD were a HCW (Odds Ratio-OR-2.89, 95% Confidence interval-CI of 1.41-5.90), reporting ‘moderate to high fear of EVD’ (OR-2.15, 95% CI-1.47-3.13) and ‘willingness to modify habit’ (OR-1.68, 95% CI-1.23-2.30). Conclusion: Our results reveal suboptimal EVD-related knowledge, attitude and practice among adults in Nigeria. To effectively control future outbreaks of EVD in Nigeria, there is a need to institute public sensitization programs that improve understanding of EVD and address EVD-related myths and misconceptions, especially among the general population.

Keywords: Ebola, health care worker, knowledge, attitude

Procedia PDF Downloads 284

Authors: Jaleh Mohammad Aliha, Rezvan Razazi, Nasim Naderi

Abstract:

Introduction: Despite the progress in new effective drugs in the treatment of heart failure, the disease still accompanied with frequent hospitalization, impaired quality of life, early mortality and significant economic burden. Patients with chronic disease and consequently patients with heart failure need the knowledge and optimal health literacy to improve the quality of life and minimize the rate of rehopitalizatio. So, considering to importance of knowledge and health literacy in this patients as well as contradictory literature, this study conducted to investigate the relationship between health literacy and Knowledge of heart failure with rehospitalization in patients with heart failure admitted to heart failure clinic in Rajai Heart center in 1394. Methods: The cross-sectional method with convenience sampling method was used in this study. After obtaining the necessary permissions from the ethics committee and the Shahid Rajai Heart center, 238 patients who were older than 18 years and had ejection fraction 35% or less with the ability to read and write and lack of psychiatric, neurological and cognitive disorders and signed the informed consent were recruited. Data collection were perfomed through demographic data questionnaire, short standard health literacy questionnaire 'Short-TOFHLA-16' and Vanderwall (2005) knowledge of heart failure questionnaire. Reliability was assessed by internal consistency method and Cronbach's alpha for both questionnaires was more than 0.7. Then data were analysed by SPSS-20 with descriptive statistic and analytical statistic such as T-test, Chi-square and ANOVA. Results: The majority of patients were male (66%), married (80%) and had age between 50 to 70 years old (42%). The majority of studied men and women have good health literacy and About half of them have adequate knowledge about heart failure. Fisher's exact test showed that there was a significant statistical correlation between health literacy and knowlegh about heart failure. In other words, higher health literacy associated with more knowledge about their condition. Also findings showed that there was no significant statistical correlation between health literacy and knowledge about heart failure and frequency of CCU and emergency admissions. Conclusion: The study results showed that the higher health literacy, associated with the greater knowledge about heart failure and patients' perception about caring recommendations and disease outcomes. Therefore, the knowledge about heart failure and factors which related to severity of the disease, is the important issue to problem identification and treatment and reduction of rehospitalization.

Keywords: health literacy, heart failure, knowlegde, rehospitalization

Procedia PDF Downloads 401

Authors: Hafiz Husnain Nawaz

Abstract:

Anthracnose disease in olive, caused by the fungal pathogen Colletotrichum acutatum, is considered one of the most critical issues in olive orchards in Pakistan. This disease poses a significant threat as it results in infections that can lead to the complete damage of olive plants, affecting leaves, stems, and fruits in the field. Controlling this disease is particularly challenging due to the absence of an effective fungicide that does not pose risks to farmer health and the environment. To address this challenge, our study aimed to evaluate the antagonistic activity of a biosurfactant produced by the Bacillus subtilis PE-07 strain against the anthracnose-causing agent in olive plants. This strain was selected after screening sixty rhizobacteria strains. Additionally, we assessed the heat stability, pH range, and toxicity of the biosurfactant produced by strain PE-07. Our results revealed that the biosurfactant exhibited maximum antifungal activity against C. acutatum. In vitro studies indicated that the biosurfactant could reduce fungal activity by inhibiting the spore germination of C. acutatum. Furthermore, the biosurfactant demonstrated a wide pH and temperature range, displaying antifungal activity at pH levels ranging from 5 to 10 and a temperature range from room temperature to 110°C. To evaluate the biosurfactant's safety, we conducted toxicity tests on zebra fish (Danio rerio). The results showed that the biosurfactant had minimal harmful effects, even at maximum concentrations. In conclusion, our study confirmed that the biosurfactant produced by B. subtilis exhibited high pH and heat stability with minimal harmful effects. Therefore, it presents a promising alternative to chemical pesticides for effectively controlling olive anthracnose in Pakistan.

Keywords: biological control, heat stability and PH range, toxicity, Danio rerio

Procedia PDF Downloads 60

Authors: I. Ben Kaddour, S. Larbaoui

Abstract:

Since their first synthesis, the Silicoaluminophosphates materials have proved their efficiency as a good adsorbent and catalyst in several environmental and energetic applications. In this work, the photocatalytic hydrogen production from water splitting reactions has been conducted under visible radiations in the presence of a series of iron and/or titanium-containing microporous silico-alumino-phosphates materials synthesized by hydrothermal method, using triethylamine as an organic structuring agent to obtain the AFI structure type. These photo-catalysts were then characterized by various physicochemical methods to determine their structural, textural and morphological properties such as X-ray diffraction (XRD), Fourier transformed infrared spectroscopy (FTIR), scanning electron microscopy (SEM) coupled with X rays microanalysis, nitrogen adsorption measurements, UV-visible diffuse reflectance spectroscopy (UV-Vis-DRS), and X-rays photoelectron spectroscopy (XPS) and the analysis revealed that these materials have significant photocatalytic properties. The hydrogen production process has been followed by photoelectrochemical characterization (PEC). The results showed that hydrogen is the only gas produced, and the reaction takes place in the conduction band where water is reduced to hydrogen. The electron recombination has also been avoided, as holes are entrapped using hole scavengers. In addition, these catalysts have been shown to remain stable during reuse for up to five cycles.

Keywords: photocatalysis, SAPO-5, hydrothermal synthesis, hydrogen production

Procedia PDF Downloads 64

Authors: Samuel E. Okere, Anthony E. Ataga

Abstract:

Introduction: This paper evaluated the mineral compositions, disease resistance elicitors in Pleurotus ostratus (POWESMS), and Pleurotus tuber-regium water extract spent mushroom substrate (PTWESMS) on the growth, yield, and management of cassava mosaic disease. Materials and Methods: The cassava plantlet (tms 98/0505) were generated through meristem tip culture at the Tissue Culture Laboratory, National Root Crop Research Institute, Umudike before they were transferred to the screen house, University of Port Harcourt Research Farm. The minerals and elicitors contained in the two spent mushroom substrates were evaluated using standard procedures. The treatments for this investigation comprised cassava plants treated with POWESMS, PTWESMS, and untreated cassava as control, which were inoculated with viral inoculum seven days after treatment application. The experiment was laid out in a completely randomized block design with 3 replicates. The data generated were subjected to analysis of variance (ANOVA). Means were separated using Fishers Least Significant Difference at p=0.05. Results: The results obtained revealed that POWESMS contained 19.3, 0.52, and 0.1g/200g substrate of carbohydrate polymers, glycoproteins, and lipid molecules elicitors respectively while it also contained 3.17, 212.1, 17.9,21.8, 58.8 and 111.0 mg/100g substrate for N, P, K, Na, Mg and Ca respectively. Further, PTWESMS contain 1.6, 0.04, and 0.2g/200g of the substrate as carbohydrate polymers, glycoprotein, and lipid respectively; the minerals contained in this substrate were 3.4, 204.8, 8.9, 24.2, 32.2 and 105.5 mg respectively for N, P, K, Na, and Ca. There were also significant differences in the mean values of the number of storage roots, root length, fresh root weight, fresh weight plant biomass, root girth, and whole plant dry biomass, but no significant difference was recorded for harvest index. The result also revealed significant differences in mean values of disease severity index evaluated at 4, 8, 12, 16, 20, 24, and 28 weeks after inoculation (WAI). Conclusion: The aqueous extract of these spent mushrooms substrate have shown outstanding prospect in managing cassava mosaic disease and also improvement in growth and yield of cassava due to the high level of the minerals and elicitors they contain when compared with the control. However, more work is recommended, especially in understanding the mechanism of this induced resistance.

Keywords: characterization, elicitors, mosaic, mushroom

Procedia PDF Downloads 130

Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

Abstract:

Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

Procedia PDF Downloads 354

Authors: Peng Guo

Abstract:

Objective To investigate the clinical characteristics and changes of video-polysomnography (v-PSG) in Parkinson disease (PD) patients accompanied with cognitive impairment. Methods Three hundred and ninety-four patients with PD were enrolled in Beijing Tiantan Hospital, according to CI level, the patients were divided into PD without cognitive impairment (PD-NCI), PD with mild cognitive impairment (PD-MCI), and PD with dementia (PDD) group. Collect patient's demographic data, including gender, onset age, education level and duration. The cognitive function of PD patients was evaluated by Montreal cognitive assessment (MoCA) scale, and the overall cognitive function and cognitive domains of the three groups were compared.Using v-PSG to assess the sleep status of patients. Correlation analysis of MoCA Scale and v-PSG results in PD-CI group. Results 1. In 394 cases of PD, 94 cases (23.86%) in PD-NCI group , 177 cases(44.92%) in PD-MCI group , 123 cases (31.22%) in PDD group. 2.There was no significant difference in gender, age of onset, education level and duration in PD-NCI group, PD-MCI group and PDD group （P＞0.05）. 3. The total score of MoCA scale in PD-NCI group, PD-MCI group and PDD group decreased one by one. In PD-NCI group, PD-MCI group and PDD group, the scores of each cognitive domain in MoCA scale decreased significantly（P<0.05）. 4.Compared with the PD-MCI group, PDD group had lower total sleep time, lower sleep efficiency （P<0.05）. Compared with PD-NCI group, PDD group had lower total sleep time and lower sleep efficiency （P<0.05）.5. The sleep efficiency of PD-CI patients is positively correlated with the total score of MoCA scale, visual spatial function, executive function, delayed recall and attention score（P<0.05). Conclusions The incidence of CI in PD patients was high; The cognitive function and cognitive domains of PD-CI patients were significantly impaired; In patients with PD-CI, total sleep time decreased, sleep efficiency decreased, and it was related to overall cognitive function and partial cognitive impairment.

Keywords: Parkinson disease, cognitive impairment, clinical characteristics, sleep disorders, video-polysomnography

Procedia PDF Downloads 30

Authors: Wu Liching

Abstract:

Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

Procedia PDF Downloads 70

Authors: Suchao Donpudsa, Suwattana Visetnan, Anchalee Tassanakajon, Vichien Rimphanitchayakit

Abstract:

The Single Wap Domain (SWD) is a type III crustin antimicrobial peptide whose function is to defense the host animal against the bacterial infection by means of antimicrobial and antiproteinase activities. A study of LvSWD from Litopenaeus vannamei is reported herein about its activities and function against bacteria, particularly the Vibrio parahaemolyticus AHPND (VPAHPND) that causes acute hepatopancreatic necrosis disease. The over-expressed mature recombinant (r)LvSWD exhibits antimicrobial activity against both Gram-positive and Gram-negative bacteria, especially VPAHPND. With four times the MIC of rLvSWD, the treated post larval shrimp infected by VPAHPND is able to survive longer with the 50% survival rate as long as 78 h as compared to 36 h of the infected shrimp without rLvSWD. To a certain extent, we have demonstrated that the rLvSWD can be applied to protect the post larval shrimp.

Keywords: crustin, Litopenaeus vannamei, Vibrio parahaemolyticus AHPND, antimicrobial activity

Procedia PDF Downloads 216

Authors: R. N. Nataria, A. D. Paryuni, R. Wasito

Abstract:

Layer farms in Indonesia have still obstacles to increasing their productivity, especially due to poultry diseases. The red onion (Allium ascalonicum L.) is a plant that contains flavonoid and saponin. Flavonoid is useful as anti-inflammatory and antioxidant while saponin is useful as antivirus, anti-inflammatory, antifungal, and immunomodulator. This study aimed to know and determine the effect of onion extracts to pulmonary histopathological lesions in layer chickens which raised in the battery cage. This study used eighteen layer chickens at seventeen days old. The eighteen layer chickens were divided into three groups of six each, namely without administration of red onion extract (Group I), with administration red onion extract through drinking water (Group II) and with administration red onion extract peroral (Group III). Every ten days, six chickens were necropsied and then the lungs were processed for histopathological preparations and stained with routine hematoxylin and eosin. The results showed that the lungs of the Group I had severe congestion and diffuse hemorrhages. In Group II, lungs had moderate congestion and hemorrhages. In group III, lungs had mild congestion and hemorrhages. It is concluded, that red onion extract apparently has reduced the lungs lesions in layer chickens.

Keywords: histopathological lesions, layers, lungs, poultry diseases, red onion extract

Procedia PDF Downloads 448

Authors: Monika Paleczna, Barbara Szmigielska

Abstract:

Adolescence is a developmental period, covering the period from 10 to 20 years of age, in which young people face many challenges. One of the most important tasks of the adolescence period is getting a structured identity. The development of identity is possible by undertaking various activities. Nowadays, virtual activities are very common among young people. One of the main adolescents’ activities in the online environment is playing computer games. The main aim of this work is to answer the question about the relationship between the identity style of adolescents and immersion, -a phenomenon often observed while playing computer games. The concept of identity created by Berzonsky is considered as one of the best-defined concepts of identity. He defines identity as both a structure and a process and distinguishes three styles of identity: informational, normative, and diffuse/avoidant. Immersion is a concept that can be applied in a broad context, but in the game environment, it is a specific psychological experience of being involved in a computer game. It refers to the relocation of the attention resources to the game world, with a limited or impossible perception of stimuli from reality. Considering how much time adolescents spend playing computer games, the question about the relationship between their identity and the immersion in the game seems to be extremely interesting. Fifty adolescents aged 15-17 participated in the study. They played a computer game and completed the Identity Style Inventory and the Immersion Questionaire.

Keywords: identity, immersion, computer games, adolescence

Procedia PDF Downloads 274

Authors: Rahul Agarwal, Ashutosh Singh

Abstract:

Colorectal cancer (CRC) also refers as bowel cancer or colon cancer. It involves the development of abnormal growth of cells in colon or rectum part of the body. This work leads to the development of a miRNA database in colorectal cancer. We named this database- miCoRe. This database comprises of all validated colon-rectal cancer miRNAs information from various published literature with an effectual knowledge based information retrieval system. miRNAs have been collected from various published literature reports. MySQL is used for main-framework of miCoRe while the front-end was developed in PHP script. The aim of developing miCoRe is to create a comprehensive central repository of colorectal carcinoma miRNAs with all germane information of miRNAs and their target genes. The current version of miCoRe consists of 238 miRNAs which are known to be implicated in malignancy of CRC. Alongside with miRNA information, miCoRe also contains the information related to the target genes of these miRNA. miCoRe furnishes the information about the mechanism of incidence and progression of the disease, which would further help the researchers to look for colorectal specific miRNAs therapies and CRC specific targeted drug designing. Moreover, it will also help in development of biomarkers for the better and early detection of CRC and will help in better clinical management of the disease.

Keywords: colorectal cancer, database, miCoRe, miRNAs

Procedia PDF Downloads 278

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

Abstract:

Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

Procedia PDF Downloads 129