Search results for: cardiovascular disease risk
8021 Effectiveness of Balloon Angioplasty and Stent Angioplasty: Wound Healing in Critically Limb Ischemic
Authors: M. Wisnu Pamungkas, Patrianef Darwis
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Introduction: Critical limb ischemia (CLI) is a vascular disease that has a significant amputation and mortality risk with diabetes mellitus, the most significant risk factor in CLI, is very common among Indonesian. Endovascular intervention (EVI) is preferred in treating CLI because it is noninvasive and effective. Balloon angioplasty and stent angioplasty are the most common method of EVI in Indonesia. This study aims to compare the effectiveness of balloon angioplasty and stent angioplasty on wound healing in CLI. Method: A cross-sectional study enrolled 90 subjects of CLI who underwent endovascular intervention using balloon angioplasty and stent angioplasty from January 2013 to July 2017 in dr. Cipto Mangunkusumo General Hospital, Jakarta. The wound healing period between balloon angioplasty dan stent angioplasty was analyzed using unpaired T-test with p<0,05 considered as statistically significant. Data of intervention method wound healing period, and subjects characteristic data (age, amputation, BMI, smoking habit, DM, occlusion site, and blood profile) were obtained. Result: The wound healing period in balloon angioplasty and stent angioplasty distributed normally. Mean value of wound healing period in balloon angioplasty and stent angioplasty are 84,8+/-2,423 and 59,93 +/- 2,423 days with a mean difference of 25 days. The difference in wound healing period in both groups is statically significant (p<0,05). The amputation event in balloon angioplasty and stent angioplasty is 22 and 16 event with no difference statistically. Conclusion: Stent angioplasty is a better method than balloon angioplasty for wound healing in patients with CLI.Keywords: critical limb ischemia, endovascular intervention, wound healing, angioplasty
Procedia PDF Downloads 1268020 Investigating the Efficacy of HIV/AIDS Psycho-Education and Behavioural Skills Training in Reducing Sexual Risk Behaviours in a Trucking Population in Nigeria
Authors: Abiodun Musbau Lawal, Benjamin Oladapo Olley
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Long Distance Truck Drivers (LDTDs) have been found to be a high-risk group in the spread of HIV/AIDS globally; perhaps, due to their high Sexual Risk Behaviours (SRBs). Interventions for reducing SRBs in trucking population have not been fully exploited. A quasi-experimental control group pretest-posttest design was used to assess the efficacy of psycho-education and behavioural skills training in reducing SRBs among LDTDs. Sixteen drivers rivers were randomly assigned into either experimental or control groups using balloting technique. A questionnaire was used as an instrument for data collection. Repeated measures t-test and independent t-test were used to test hypotheses. The intervention had a significant effect on the SRBs among LDTDs at post-test(t{7}=6.01, p<.01) and at followup (t{7}=6.42, p<.01). No significant difference in sexual risk behaviour of LDTDs at post-test and at follow-up stage. Similarly, intervention had significant effects on sexual risk behaviour at post-test (t {14}=- 4.69, p<.05) and at follow-up (t {14}= -9.56, p < .05) respectively. At post-test and follow-up stages, drivers in experimental group reported reduced SRBs than those in the control group. Drivers in an experimental group reported lower sexual risk behaviour a week after intervention as well as at three months follow-up than those in the control group. It is concluded that HIV/AIDS preventive intervention that provides the necessary informational and behavioural skills content can significantly impact long distance truck drivers sexual risk behaviours.Keywords: HIV/AIDS interventions, long distance truck drivers, Nigeria, sexual risk behaviours
Procedia PDF Downloads 4768019 Money Laundering Risk Assessment in the Banking Institutions: An Experimental Approach
Authors: Yusarina Mat-Isa, Zuraidah Mohd-Sanusi, Mohd-Nizal Haniff, Paul A. Barnes
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In view that money laundering has become eminent for banking institutions, it is an obligation for the banking institutions to adopt a risk-based approach as the integral component of the accepted policies on anti-money laundering. In doing so, those involved with the banking operations are the most critical group of personnel as these are the people who deal with the day-to-day operations of the banking institutions and are obligated to form a judgement on the level of impending risk. This requirement is extended to all relevant banking institutions staff, such as tellers and customer account representatives for them to identify suspicious customers and escalate it to the relevant authorities. Banking institutions staffs, however, face enormous challenges in identifying and distinguishing money launderers from other legitimate customers seeking genuine banking transactions. Banking institutions staffs are mostly educated and trained with the business objective in mind to serve the customers and are not trained to be “detectives with a detective’s power of observation”. Despite increasing awareness as well as trainings conducted for the banking institutions staff, their competency in assessing money laundering risk is still insufficient. Several gaps have prompted this study including the lack of behavioural perspectives in the assessment of money laundering risk in the banking institutions. Utilizing experimental approach, respondents are randomly assigned within a controlled setting with manipulated situations upon which judgement of the respondents is solicited based on various observations related to the situations. The study suggests that it is imperative that informed judgement is exercised in arriving at the decision to proceed with the banking services required by the customers. Judgement forms a basis of opinion for the banking institution staff to decide if the customers posed money laundering risk. Failure to exercise good judgement could results in losses and absorption of unnecessary risk into the banking institutions. Although the banking institutions are exposed with choices of automated solutions in assessing money laundering risk, the human factor in assessing the risk is indispensable. Individual staff in the banking institutions is the first line of defence who are responsible for screening the impending risk of any customer soliciting for banking services. At the end of the spectrum, the individual role involvement on the subject of money laundering risk assessment is not a substitute for automated solutions as human judgement is inimitable.Keywords: banking institutions, experimental approach, money laundering, risk assessment
Procedia PDF Downloads 2678018 Aerobic Training Combined with Nutritional Guidance as an Effective Strategy for Improving Aerobic Fitness and Reducing BMI in Inactive Adults
Authors: Leif Inge Tjelta, Gerd Lise Nordbotten, Cathrine Nyhus Hagum, Merete Hagen Helland
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Overweight and obesity can lead to numerous health problems, and inactive people are more often overweight and obese compared to physically active people. Even a moderate weight loss can improve cardiovascular and endocrine disease risk factors. The aim of the study was to examine to what extent overweight and obese adults starting up with two weekly intensive running sessions had an increase in aerobic capacity, reduction in BMI and waist circumference and changes in body composition after 33 weeks of training. An additional aim was to see if there were differences between participants who, in addition to training, also received lifestyle modification education, including practical cooking (nutritional guidance and training group (NTG =32)) compared to those who were not given any nutritional guidance (training group (TG=40)). 72 participants (49 women), mean age of 46.1 ( ± 10.4) were included. Inclusion Criteria: Previous untrained and inactive adults in all age groups, BMI ≥ 25, desire to become fitter and reduce their BMI. The two weekly supervised training sessions consisted of 10 min warm up followed by 20 to 21 min effective interval running where the participants’ heart rate were between 82 and 92% of hearth rate maximum. The sessions were completed with ten minutes whole body strength training. Measures of BMI, waist circumference (WC) and 3000m running time were performed at the start of the project (T1), after 15 weeks (T2) and at the end of the project (T3). Measurements of fat percentage, muscle mass, and visceral fat were performed at T1 and T3. Twelve participants (9 women) from both groups, who all scored around average on the 3000 m pre-test, were chosen to do a VO₂max test at T1 and T3. The NTG were given ten theoretical sessions (80 minutes each) and eight practical cooking sessions (140 minutes each). There was a significant reduction in bout groups for WC and BMI from T1 to T2. There was not found any further reduction from T2 to T3. Although not significant, NTG reduced their WC more than TG. For both groups, the percentage reduction in WC was similar to the reduction in BMI. There was a decrease in fat percentage in both groups from pre-test to post-test, whereas, for muscle mass, a small, but insignificant increase was observed for both groups. There was a decrease in 3000m running time for both groups from T1 to T2 as well as from T2 to T3. The difference between T2 and T3 was not statistically significant. The 12 participants who tested VO₂max had an increase of 2.86 ( ± 3.84) mlkg⁻¹ min⁻¹ in VO₂max and 3:02 min (± 2:01 min) reduction in running time over 3000 m from T1 until T3. There was a strong, negative correlation between the two variables. The study shows that two intensive running session in 33 weeks can increase aerobic fitness and reduce BMI, WC and fat percent in inactive adults. Cost guidance in addition to training will give additional effect.Keywords: interval training, nutritional guidance, fitness, BMI
Procedia PDF Downloads 1428017 Classifier for Liver Ultrasound Images
Authors: Soumya Sajjan
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Liver cancer is the most common cancer disease worldwide in men and women, and is one of the few cancers still on the rise. Liver disease is the 4th leading cause of death. According to new NHS (National Health Service) figures, deaths from liver diseases have reached record levels, rising by 25% in less than a decade; heavy drinking, obesity, and hepatitis are believed to be behind the rise. In this study, we focus on Development of Diagnostic Classifier for Ultrasound liver lesion. Ultrasound (US) Sonography is an easy-to-use and widely popular imaging modality because of its ability to visualize many human soft tissues/organs without any harmful effect. This paper will provide an overview of underlying concepts, along with algorithms for processing of liver ultrasound images Naturaly, Ultrasound liver lesion images are having more spackle noise. Developing classifier for ultrasound liver lesion image is a challenging task. We approach fully automatic machine learning system for developing this classifier. First, we segment the liver image by calculating the textural features from co-occurrence matrix and run length method. For classification, Support Vector Machine is used based on the risk bounds of statistical learning theory. The textural features for different features methods are given as input to the SVM individually. Performance analysis train and test datasets carried out separately using SVM Model. Whenever an ultrasonic liver lesion image is given to the SVM classifier system, the features are calculated, classified, as normal and diseased liver lesion. We hope the result will be helpful to the physician to identify the liver cancer in non-invasive method.Keywords: segmentation, Support Vector Machine, ultrasound liver lesion, co-occurance Matrix
Procedia PDF Downloads 4118016 The Relationship between Risk and Capital: Evidence from Indian Commercial Banks
Authors: Seba Mohanty, Jitendra Mahakud
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Capital ratio is one of the major indicators of the stability of the commercial banks. Pertinent to its pervasive importance, over the years the regulators, policy makers focus on the maintenance of the particular level of capital ratio to minimize the solvency and liquidation risk. In this context, it is very much important to identify the relationship between capital and risk and find out the factors which determine the capital ratios of commercial banks. The study examines the relationship between capital and risk of the commercial banks operating in India. Other bank specific variables like bank size, deposit, profitability, non-performing assets, bank liquidity, net interest margin, loan loss reserves, deposits variability and regulatory pressure are also considered for the analysis. The period of study is 1997-2015 i.e. the period of post liberalization. To identify the impact of financial crisis and implementation of Basel II on capital ratio, we have divided the whole period into two sub-periods i.e. 1997-2008 and 2008-2015. This study considers all the three types of commercial banks, i.e. public sector, the private sector and foreign banks, which have continuous data for the whole period. The main sources of data are Prowess data base maintained by centre for monitoring Indian economy (CMIE) and Reserve Bank of India publications. We use simultaneous equation model and more specifically Two Stage Least Square method to find out the relationship between capital and risk. From the econometric analysis, we find that capital and risk affect each other simultaneously, and this is consistent across the time period and across the type of banks. Moreover, regulation has a positive significant impact on the ratio of capital to risk-weighted assets, but no significant impact on the banks risk taking behaviour. Our empirical findings also suggest that size has a negative impact on capital and risk, indicating that larger banks increase their capital less than the other banks supported by the too-big-to-fail hypothesis. This study contributes to the existing body of literature by predicting a strong relationship between capital and risk in an emerging economy, where banking sector plays a majority role for financial development. Further this study may be considered as a primary study to find out the macro economic factors which affecting risk and capital in India.Keywords: capital, commercial bank, risk, simultaneous equation model
Procedia PDF Downloads 3278015 Correlation between Body Mass Index and Blood Sugar/Serum Lipid Levels in Fourth-Grade Boys in Japan
Authors: Kotomi Yamashita, Hiromi Kawasaki, Satoko Yamasaki, Susumu Fukita, Risako Sakai
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Lifestyle-related diseases develop from the long-term accumulation of health consequences from a poor lifestyle. Thus, schoolchildren, who have not accumulated long-term lifestyle habits, are believed to be at a lower risk for lifestyle-related diseases. However, schoolchildren rarely receive blood tests unless they are under treatment for a serious disease; without such data on their blood, the impacts of their young lifestyle could not be known. Blood data from physical measurements can help in the implementation of more effective health education. Therefore, we examined the correlation between body mass index (BMI) and blood sugar/serum lipid (BS/SL) levels. From 2014 to 2016, we measured the blood data of fourth-grade students living in a city in Japan. The present study reported on the results of 281 fourth-grade boys only (80.3% of total). We analyzed their BS/SL levels by comparing the blood data against the criteria of the National Center for Child Health and Development in Japan. Next, we examined the correlation between BMI and BS/SL levels. IBM SPSS Statistics for Windows, Version 25 was used for analysis. A total of 69 boys (24.6%) were within the normal range for BMI (18.5–24), whereas 193 (71.5%) and 8 boys (2.8%) had lower and higher BMI, respectively. Regarding BS levels, 280 boys were within the normal range (70–90 mg/dl); 1 boy reported a higher value. All the boys were within the normal range for glycated Hemoglobin (HbA1c) (4.6–6.2%). Regarding SL levels, 271 boys were within the normal range (125–230 mg/dl) for total cholesterol (TC), whereas 5 boys (1.8%) had lower and 5 boys (1.8%) had higher levels. A total of 243 boys (92.7%) were within the normal range (36-138mg/dL) for triglycerides (TG), whereas 19 boys (7.3%) had lower and 19 boys (7.3%) had higher levels. Regarding high-density lipoprotein cholesterol (HDL-C), 276 boys (98.2%) were within the normal range (40-mg/dl), whereas 5 boys (1.8%) reported lower values. All but one boy (280, 99.6%) were within the normal range (-170 mg/dl) for low-density lipoprotein cholesterol (LDL-C); the exception (0.4%) had a higher level. BMI and BS didn’t show a correlation. BMI and HbA1c were moderately positively correlated (r = 0.139, p=0.019). We also observed moderate positive correlations between BMI and TG (r = 0.328, p < 0.01), TC (r=0.239, p< 0.01), LDL-C (r = 0.324, p < 0.01), respectively. BMI and HDL-C were low correlated (r = -0.185, p = 0.002). Most of the boys were within the normal range for BS/SL levels. However, some boys exceeded the normal TG range. Fourth graders with a high TG may develop a lifestyle-related disease in the future. Given its relation to TG, food habits should be improved in this group. Our findings suggested a positive correlation between BMI and BS/SL levels. Fourth-grade schoolboys with a high BMI may be at high risk for developing lifestyle-related diseases. Lifestyle improvement may be recommended to lower the BS/SL levels in this group.Keywords: blood sugar level, lifestyle-related diseases, school students, serum lipid level
Procedia PDF Downloads 1388014 Scientometrics Analysis of Food Supply Chain Risk Assessment Literature: Based On Web of Science Record 1996-2014
Authors: Mohsen Shirani, Shadi Asadzandi, Micaela Demichela
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This paper presents the results of a study to assess crucial aspects and the strength of the scientific basis of a typically interdisciplinary, applied field: food supply chain risk assessment research. Our approach is based on an advanced scientometrics analysis with novel elements to assess the influence and dissemination of research results and to measure interdisciplinary. This paper aims to describe the quantity and quality of the publication trends in food supply chain risk assessment. The population under study was composed of 266 articles from database web of science. The results were analyzed based on date of publication, type of document, language of the documents, source of publications, subject areas, authors and their affiliations, and the countries involved in developing the articles.Keywords: food supply chain, risk assessment, scientometrics, web of science
Procedia PDF Downloads 4958013 Seroepidemiology of Q Fever among Companion Dogs in Fars Province, South of Iran
Authors: Atefeh Esmailnejad, Mohammad Abbaszadeh Hasiri
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Coxiella burnetii is a gram-negative obligatory intracellular bacterium that causes Q fever, a significant zoonotic disease. Sheep, cattle, and goats are the most commonly reported reservoirs for the bacteria, but infected cats and dogs have also been implicated in the transmission of the disease to human. The aim of present study was to investigate the presence of antibodies against Coxiella burnetii among companion dogs in Fars province, South of Iran. A total of 181 blood samples were collected from asymptomatic dogs, mostly referred to Veterinary Hospital of Shiraz University for regular vaccination. The IgG antibody detection against Coxiella burnetii was made by indirect Enzyme-linked Immunosorbent Assay (ELISA), employing phase I and II Coxiella burnetii antigens. A logistic regression model was developed to analyze multiple risk factors associated with seropositivity. An overall seropositivity of 7.7% (n=14) was observed. Prevalence was significantly higher in adult dogs above five years (18.18 %) compared with dogs between 1 and five years (7.86 %) and less than one year (6.17%) (P=0.043). Prevalence was also higher in male dogs (11.21 %) than in female (2.7 %) (P=0.035). There were no significant differences in the prevalence of positive cases and breed, type of housing, type of food and exposure to other farm animals (P>0.05). The results of this study showed the presence of Coxiella burnetii infection among the companion dogs population in Fars province. To our knowledge, this is the first study regarding Q fever in dogs carried out in Iran. In areas like Iran, where human cases of Q fever are not common or remain unreported, the public health implications of Q fever seroprevalence in dogs are quite significant.Keywords: Coxiella burnetii, dog, Iran, Q fever
Procedia PDF Downloads 3108012 The Importance of Downstream Supply Chain in Supply Chain Risk Management: Multi-Objective Optimization
Authors: Zohreh Khojasteh-Ghamari, Takashi Irohara
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One of the efficient ways in supply chain risk management is avoiding the interruption in Supply Chain (SC) before it occurs. Although the majority of the organizations focus on their first-tier suppliers to avoid risk in the SC, studies show that in only 60 percent of the disruption cases the reason is first tier suppliers. In the 40 percent of the SC disruptions, the reason is downstream SC, which is the second tier and lower. Due to the increasing complexity and interrelation of modern supply chains, the SC elements have become difficult to trace. Moreover, studies show that there is a vital need to better understand the integration of risk and visibility, especially in the context of multiple objectives. In this study, we propose a multi-objective programming model to avoid disruption in SC. The objective of this study is evaluating the effect of downstream SCV on managing supply chain risk. We propose a multi-objective mathematical programming model with the objective functions of minimizing the total cost and maximizing the downstream supply chain visibility (SCV). The decision variable is supplier selection. We assume there are several manufacturers and several candidate suppliers. For each manufacturer, our model proposes the best suppliers with the lowest cost and maximum visibility in downstream supply chain. We examine the applicability of the model by numerical examples. We also define several scenarios for datasets and observe the tendency. The results show that minimum visibility in downstream SC is needed to have a safe SC network.Keywords: downstream supply chain, optimization, supply chain risk, supply chain visibility
Procedia PDF Downloads 2448011 Machine Learning for Disease Prediction Using Symptoms and X-Ray Images
Authors: Ravija Gunawardana, Banuka Athuraliya
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Machine learning has emerged as a powerful tool for disease diagnosis and prediction. The use of machine learning algorithms has the potential to improve the accuracy of disease prediction, thereby enabling medical professionals to provide more effective and personalized treatments. This study focuses on developing a machine-learning model for disease prediction using symptoms and X-ray images. The importance of this study lies in its potential to assist medical professionals in accurately diagnosing diseases, thereby improving patient outcomes. Respiratory diseases are a significant cause of morbidity and mortality worldwide, and chest X-rays are commonly used in the diagnosis of these diseases. However, accurately interpreting X-ray images requires significant expertise and can be time-consuming, making it difficult to diagnose respiratory diseases in a timely manner. By incorporating machine learning algorithms, we can significantly enhance disease prediction accuracy, ultimately leading to better patient care. The study utilized the Mask R-CNN algorithm, which is a state-of-the-art method for object detection and segmentation in images, to process chest X-ray images. The model was trained and tested on a large dataset of patient information, which included both symptom data and X-ray images. The performance of the model was evaluated using a range of metrics, including accuracy, precision, recall, and F1-score. The results showed that the model achieved an accuracy rate of over 90%, indicating that it was able to accurately detect and segment regions of interest in the X-ray images. In addition to X-ray images, the study also incorporated symptoms as input data for disease prediction. The study used three different classifiers, namely Random Forest, K-Nearest Neighbor and Support Vector Machine, to predict diseases based on symptoms. These classifiers were trained and tested using the same dataset of patient information as the X-ray model. The results showed promising accuracy rates for predicting diseases using symptoms, with the ensemble learning techniques significantly improving the accuracy of disease prediction. The study's findings indicate that the use of machine learning algorithms can significantly enhance disease prediction accuracy, ultimately leading to better patient care. The model developed in this study has the potential to assist medical professionals in diagnosing respiratory diseases more accurately and efficiently. However, it is important to note that the accuracy of the model can be affected by several factors, including the quality of the X-ray images, the size of the dataset used for training, and the complexity of the disease being diagnosed. In conclusion, the study demonstrated the potential of machine learning algorithms for disease prediction using symptoms and X-ray images. The use of these algorithms can improve the accuracy of disease diagnosis, ultimately leading to better patient care. Further research is needed to validate the model's accuracy and effectiveness in a clinical setting and to expand its application to other diseases.Keywords: K-nearest neighbor, mask R-CNN, random forest, support vector machine
Procedia PDF Downloads 1548010 Towards Conservation and Recovery of Species at Risk in Ontario: Progress on Recovery Planning and Implementation and an Overview of Key Research Needs
Authors: Rachel deCatanzaro, Madeline Austen, Ken Tuininga, Kathy St. Laurent, Christina Rohe
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In Canada, the federal Species at Risk Act (SARA) provides protection for wildlife species at risk and a national legislative framework for the conservation or recovery of species that are listed as endangered, threatened, or special concern under Schedule 1 of SARA. Key aspects of the federal species at risk program include the development of recovery documents (recovery strategies, action plans, and management plans) outlining threats, objectives, and broad strategies or measures for conservation or recovery of the species; the identification and protection of critical habitat for threatened and endangered species; and working with groups and organizations to implement on-the-ground recovery actions. Environment Canada’s progress on the development of recovery documents and on the identification and protection of critical habitat in Ontario will be presented, along with successes and challenges associated with on-the ground implementation of recovery actions. In Ontario, Environment Canada is currently involved in several recovery and monitoring programs for at-risk bird species such as the Loggerhead Shrike, Piping Plover, Golden-winged Warbler and Cerulean Warbler and has provided funding for a wide variety of recovery actions targeting priority species at risk and geographic areas each year through stewardship programs including the Habitat Stewardship Program, Aboriginal Fund for Species at Risk, and the Interdepartmental Recovery Fund. Key research needs relevant to the recovery of species at risk have been identified, and include: surveys and monitoring of population sizes and threats, population viability analyses, and addressing knowledge gaps identified for individual species (e.g., species biology and habitat needs). The engagement of all levels of government, the local and international conservation communities, and the scientific research community plays an important role in the conservation and recovery of species at risk in Ontario– through surveying and monitoring, filling knowledge gaps, conducting public outreach, and restoring, protecting, or managing habitat – and will be critical to the continued success of the federal species at risk program.Keywords: conservation biology, habitat protection, species at risk, wildlife recovery
Procedia PDF Downloads 4528009 Relationship between the Ability of Accruals and Non-Systematic Risk of Shares for Companies Listed in Stock Exchange: Case Study, Tehran
Authors: Lina Najafian, Hamidreza Vakilifard
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The present study focused on the relationship between the quality of accruals and non-systematic risk. The independent study variables included the ability of accruals, the information content of accruals, and amount of discretionary accruals considered as accruals quality measures. The dependent variable was non-systematic risk based on the Fama and French Three Factor model (FFTFM) and the capital asset pricing model (CAPM). The control variables were firm size, financial leverage, stock return, cash flow fluctuations, and book-to-market ratio. The data collection method was based on library research and document mining including financial statements. Multiple regression analysis was used to analyze the data. The study results showed that there is a significant direct relationship between financial leverage and discretionary accruals and non-systematic risk based on FFTFM and CAPM. There is also a significant direct relationship between the ability of accruals, information content of accruals, firm size, and stock return and non-systematic based on both models. It was also found that there is no relationship between book-to-market ratio and cash flow fluctuations and non-systematic risk.Keywords: accruals quality, non-systematic risk, CAPM, FFTFM
Procedia PDF Downloads 1598008 Genetics of Atopic Dermatitis: Role of Cytokine Genes Polymorphisms
Authors: Ghaleb Bin Huraib
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Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin disease characterized by severe itching and recurrent, relapsing eczema-like skin lesions, affecting up to 20% of children and 10% of adults in industrialized countries. AD is a complex multifactorial disease, and its exact etiology and pathogenesis have not been fully elucidated. The aim of this study was to investigate the impact of gene polymorphisms of T helper cell subtype Th1 and Th2 cytokines, interferon-gamma (IFN-γ), interleukin-6 (IL-6) and transforming growth factor (TGF)-β1on AD susceptibility in a Saudi cohort. One hundred four unrelated patients with AD and 195 healthy controls were genotyped for IFN-γ (874A/T), IL-6 (174G/C) and TGF-β1 (509C/T) polymorphisms using ARMS-PCR and PCR-RFLP technique. The frequency of genotypes AA and AT of IFN-γ (874A/T) differed significantly among patients and controls (P 0.001). The genotype AT was increased while genotype AA was decreased in AD patients as compared to controls. AD patients also had a higher frequency of T-containing genotypes (AT+TT) than controls (P = 0.001). The frequencies of alleles T and A were statistically different in patients and controls (P = 0.04). The frequencies of genotype GG and allele G of IL-6 (174G/C) were significantly higher, while genotype GC and allele C were lower in AD patients than in controls. There was no significant difference in the frequencies of alleles and genotypes of TGF-β1 (509C/T) polymorphism between the patient and control groups. These results showed that susceptibility to AD is influenced by the presence or absence of genotypes of IFN-γ (874A/T) and IL-6 (174G/C) polymorphisms. It is concluded T-allele and T-containing genotypes (AT+TT) of IFN-γ (874A/T) and G-allele and GG genotype ofIL-6 (174G/C) polymorphisms are susceptible to AD in Saudis. On the other hand, the TGF-β1 (509C/T) polymorphism may not be associated with AD risk in our population; however, further studies with large sample sizes are required to confirm these results.Keywords: atopic dermatitis, Polymorphism, Interferon, IL-6
Procedia PDF Downloads 668007 Health Risk Assessment of Heavy Metals in Clarias gariepinus (Burchell, 1822) from Fish Mongers within Akure Metropolis, Ondo State, Nigeria
Authors: O. O. Olawusi-Peters, K. I. Adejugbagbe
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The concentration of heavy metal (Cd, Pb, Fe, Zn, Cu) in Clarias gariepinus collected from fish markets; Fanibi (Station I) and Fiwasaye (Station II) in Akure metropolis, Ondo state, Nigeria were investigated to ascertain the safety for the consumers. 60 samples were collected from the two markets in three batches (I, II, III) for a period of six months and analyzed for heavy metals in the gills and muscles of the fish. Also, the Health Risk Index (HRI) was used to determine the health risk of these metals to the consumer. The results showed that the investigated metal concentration was higher in station I than station II, except Pb having higher concentration in station II than station I. In both stations, the highest concentration of Fe was recorded in the gills (12.60 ± 1.51; 6.94 ± 1.38) and muscles (3.72 ± 0.09; 3.86 ± 0.33) of samples in batch I. Also, the HRI revealed that consumption of Clarias gariepinus from these study areas did not pose any health risk (HRI < 1). In addition, concentrations of the heavy metals were all below the permissible limits recommended by FAO/WHO.Keywords: health risk index, heavy metals, clarias gariepinus, akure metropolis, fish monger
Procedia PDF Downloads 1478006 Burden of Severe COVID-19 in Center of Iran: Results of Disability-Adjusted Life Years (DALYs)
Authors: Moslem Taheri Soodejani, Mohammad Hassan Lotfi
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Introduction: The outbreak of Covid-19 disease is an international public health concern. Therefore, the analysis of information related to mortality and disability due to COVID-19 is considered important, so the present study was designed and conducted with the aim of assessing COVID-19 Disability-Adjusted Life Years (DALYs) in Yazd. Methods: In Yazd province, all suspected cases of Covid-19 that would be referred to central hospitals in order to get confirmed through PCR or CT scan tests were recruited to our study. The fatality data of Covid- 19 was gathered from the forensic medicine organization. The Disability-Adjusted Life Years (DALYs) combines in one measure years of life lost (YLL), the loss of healthy life due to premature mortality and years of life lived with disability (YLD), the loss of healthy life because of disease and disability. Results: The total burden of COVID-19 was 23,472 years. The number of years lost due to premature death was 23385 and the number of years of life with disability due to COVID-19 was estimated to be 87 years. The disease burden was 12992 years for men and 10480 years for women. The overall incidence of COVID-19 was 1411 per 100,000, of which 1419 in men and 1402 in women per 100,000. Conclusion: The outbreak of the COVID-19 pandemic affected a large population and the residents of Yazd Province lost many years of their lives due to this disease.Keywords: DALY, covid- 19, Yazd, Iran
Procedia PDF Downloads 1918005 Development of Database for Risk Assessment Appling to Ballast Water Managements
Authors: Eun-Chan Kim, Jeong-Hwan Oh, Seung-Guk Lee
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Billions of tones of ballast water including various aquatic organisms are being carried around the world by ships. When the ballast water is discharged into new environments, some aquatic organisms discharged with ballast water may become invasive and severely disrupt the native ecology. Thus, International Maritime Organization (IMO) adopted the Ballast Water Management Convention in 2004. Regulation A-4 of the convention states that a government in waters under their jurisdiction may grant exemptions to any requirements to ballast water management, but only when they are granted to a ship or ships on a voyage or voyages between specified ports or locations, or to a ship which operates exclusively between specified ports or locations. In order to grant exemptions, risk assessment should be conducted based on the guidelines for risk assessment developed by the IMO. For the risk assessment, it is essential to collect the relevant information and establish a database system. This paper studies the database system for ballast water risk assessment. This database consists of the shipping database, ballast water database, port environment database and species database. The shipping database has been established based on the data collected from the port management information system of Korea Government. For the ballast water database, ballast water discharge has only been estimated by the loading/unloading of the cargoes as the convention has not come into effect yet. The port environment database and species database are being established based on the reference documents, and existing and newly collected monitoring data. This database system has been approved to be a useful system, capable of appropriately analyzing the risk assessment in the all ports of Korea.Keywords: ballast water, IMO, risk assessment, shipping, environment, species
Procedia PDF Downloads 5208004 In vitro Antiviral Activity of Ocimum sanctum against Animal Viruses
Authors: Anjana Goel, Ashok Kumar Bhatia
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Ocimum sanctum, a well known medicinal plant is used for various alignments in Ayurvedic medicines. It was found to be effective in treating the humans suffering from different viral infections like chicken pox, small pox, measles and influenza. In addition, curative effect of the plant in malignant patients was also reported. In the present study, leaves of this plant were screened against animal viruses i.e. Bovine Herpes Virus-type-1 (BHV-1), Foot and Mouth disease virus (FMDV) and Newcastle Disease Virus (NDV). BHV-1 and FMDV were screened in MDBK and BHK cell lines respectively using cytopathic inhibition test. While NDV was propagated in chick embryo fibroblast culture and tested by haemagglutination inhibition test. Maximum non toxic dose of aqueous extract of Ocimum sanctum leaves was calculated by MTT assay in all the cell cultures and nontoxic doses were used for antiviral activity against viruses. 98.4% and 85.3% protection were recorded against NDV and BHV-1 respectively. However, Ocimum sanctum extract failed to show any inhibitory effect on the cytopathic effect caused by FMD virus. It can be concluded that Ocimum sanctum is a very effective remedy for curing viral infections in animals also.Keywords: bovine herpes virus-type-1, foot and mouth disease virus, newcastle disease virus, Ocimum sanctum
Procedia PDF Downloads 2718003 Genomic Analysis of Whole Genome Sequencing of Leishmania Major
Authors: Fatimazahrae Elbakri, Azeddine Ibrahimi, Meryem Lemrani, Dris Belghyti
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Leishmaniasis represents a major public health problem because of the number of cases recorded each year and the wide distribution of the disease. It is a parasitic disease of flagellated protozoa transmitted by the bite of certain species of sandfly, causing a spectrum of clinical pathology in humans ranging from disfiguring skin lesions to fatal visceral leishmaniasis. Cutaneous leishmaniasis due to Leishmania major is a polymorphic disease; in fact, the infection can be asymptomatic, localized, or disseminated. The objective of this work is to determine the genomic diversity that contributes to clinical variability by trying to identify the variation in chromosome number and to extract SNPs and SNPs and InDels; it is based on four sequences (WGS) of Leishmania major available on NCBI in Fastq form, from three countries: Tunisia, Algeria, and Israel, the analysis is set up from a pipeline to facilitate the discovery of genetic diversity, in particular SNP and chromosomal somy.Keywords: Leshmania major, cutaneous Leishmania, NGS, genomic, somy, variant calling
Procedia PDF Downloads 798002 Ecological Risk Aspects of Essential Trace Metals in Soil Derived From Gold Mining Region, South Africa
Authors: Lowanika Victor Tibane, David Mamba
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Human body, animals, and plants depend on certain essential metals in permissible quantities for their survival. Excessive metal concentration may cause severe malfunctioning of the organisms and even fatal in extreme cases. Because of gold mining in the Witwatersrand basin in South Africa, enormous untreated mine dumps comprise elevated concentration of essential trace elements. Elevated quantities of trace metal have direct negative impact on the quality of soil for different land use types, reduce soil efficiency for plant growth, and affect the health human and animals. A total of 21 subsoil samples were examined using inductively coupled plasma optical emission spectrometry and X-ray fluorescence methods and the results elevated men concentration of Fe (36,433.39) > S (5,071.83) > Cu (1,717,28) > Mn (612.81) > Cr (74.52) > Zn (68.67) > Ni (40.44) > Co (9.63) > P (3.49) > Mo > (2.74), reported in mg/kg. Using various contamination indices, it was discovered that the sites surveyed are on average moderately contaminated with Co, Cr, Cu, Mn, Ni, S, and Zn. The ecological risk assessment revealed a low ecological risk for Cr, Ni and Zn, whereas Cu poses a very high ecological risk.Keywords: essential trace elements, soil contamination, contamination indices, toxicity, descriptive statistics, ecological risk evaluation
Procedia PDF Downloads 908001 Antihypertensive Activity of Alcoholic Extract of Citrus Paradise Juice in One Clip One Kidney Hypertension Model in Rats
Authors: Lokesh Bhatt, Jayesh Rathod
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Hypertension is one of the most prevalent cardiovascular disorder. It is responsible for several other cardiovascular disorders. Although many drugs are available for the treatment of hypertension, still a large population has uncontrolled blood pressure. Thus there is an unmet need for new therapeutic approaches for the same. Fruit juice of Citrus paradise contains several flavonoids with vasodilatory activity. We hypothesized that alcoholic extract of Citrus paradise, which contains flavonoids, might attenuate hypertension. The objective of the present study was to evaluate the antihypertensive activity of alcoholic extract of Citrus paradise fruit juice in rats. Hypertension was induced using one clip one kidney model in rats. The renal artery was occluded for 4 h after removal of one kidney. Once stabilized, the ganglionic blockade was performed followed by removal of the arterial clip from the kidney. Removal of clip resulted in an increase in blood pressure which is due to release of renin from the kidney. Alcoholic extract of Citrus paradise fruit juice was then administered at 50 mg/kg and 100 mg/kg dose by intravenous injection. Blood pressure was monitored continuously. Alcoholic extract of Citrus paradise fruit juice reduced hypertension in dose-dependent manner. Antihypertensive activity was found to be associated with vasodilation. The results of the present study showed antihypertensive potential of alcoholic extract of Citrus paradise fruit juice.Keywords: citrus paradise, alcoholic extract, one clip one kidney model, vasodilation
Procedia PDF Downloads 2898000 Role of Macro and Technical Indicators in Equity Risk Premium Prediction: A Principal Component Analysis Approach
Authors: Naveed Ul Hassan, Bilal Aziz, Maryam Mushtaq, Imran Ameen Khan
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Equity risk premium (ERP) is the stock return in excess of risk free return. Even though it is an essential topic of finance but still there is no common consensus upon its forecasting. For forecasting ERP, apart from the macroeconomic variables attention is devoted to technical indicators as well. For this purpose, set of 14 technical and 14 macro-economic variables is selected and all forecasts are generated based on a standard predictive regression framework, where ERP is regressed on a constant and a lag of a macroeconomic variable or technical indicator. The comparative results showed that technical indicators provide better indications about ERP estimates as compared to macro-economic variables. The relative strength of ERP predictability is also investigated by using National Bureau of Economic Research (NBER) data of business cycle expansion and recessions and found that ERP predictability is more than twice for recessions as compared to expansions.Keywords: equity risk premium, forecasting, macroeconomic indicators, technical indicators
Procedia PDF Downloads 3067999 Quality of Life of Patients on Oral Antiplatelet Therapy in Outpatient Cardiac Department Dr. Hasan Sadikin Central General Hospital Bandung
Authors: Andhiani Sharfina Arnellya, Mochammad Indra Permana, Dika Pramita Destiani, Ellin Febrina
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Health Research Data, Ministry of Health of Indonesia in 2007, showed coronary heart disease (CHD) or coronary artery disease (CAD) was the third leading cause of death in Indonesia after hypertension and stroke with 7.2% incidence rate. Antiplatelet is one of the important therapy in management of patients with CHD. In addition to therapeutic effect on patients, quality of life is one aspect of another assessment to see the success of antiplatelet therapy. The purpose of this study was to determine the quality of life of patients on oral antiplatelet therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This research is a cross sectional by collecting data through quality of life questionnaire of patients which performed prospectively as primary data and secondary data from medical record of patients. The results of this study showed that 54.3% of patients had a good quality of life, 45% had a moderate quality of life, and 0.7% had a poor quality of life. There are no significant differences in quality of life-based on age, gender, diagnosis, and duration of drug use.Keywords: antiplatelet, quality of life, coronary artery disease, coronary heart disease
Procedia PDF Downloads 3247998 Retrospective Assessment of the Safety and Efficacy of Percutaneous Microwave Ablation in the Management of Hepatic Lesions
Authors: Suang K. Lau, Ismail Goolam, Rafid Al-Asady
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Background: The majority of patients with hepatocellular carcinoma (HCC) are not suitable for curative treatment, in the form of surgical resection or transplantation, due to tumour extent and underlying liver dysfunction. In these non-resectable cases, a variety of non-surgical therapies are available, including microwave ablation (MWA), which has shown increasing popularity due to its low morbidity, low reported complication rate, and the ability to perform multiple ablations simultaneously. Objective: The aim of this study was to evaluate the validity of MWA as a viable treatment option in the management of HCC and hepatic metastatic disease, by assessing its efficacy and complication rate at a tertiary hospital situated in Westmead (Australia). Methods: A retrospective observational study was performed evaluating patients that underwent MWA between 1/1/2017–31/12/2018 at Westmead Hospital, NSW, Australia. Outcome measures, including residual disease, recurrence rates, as well as major and minor complication rates, were retrospectively analysed over a 12-months period following MWA treatment. Excluded patients included those whose lesions were treated on the basis of residual or recurrent disease from previous treatment, which occurred prior to the study window (11 patients) and those who were lost to follow up (2 patients). Results: Following treatment of 106 new hepatic lesions, the complete response rate (CR) was 86% (91/106) at 12 months follow up. 10 patients had the residual disease at post-treatment follow up imaging, corresponding to an incomplete response (ICR) rate of 9.4% (10/106). The local recurrence rate (LRR) was 4.6% (5/106) with follow-up period up to 12 months. The minor complication rate was 9.4% (10/106) including asymptomatic pneumothorax (n=2), asymptomatic pleural effusions (n=2), right lower lobe pneumonia (n=3), pain requiring admission (n=1), hypotension (n=1), cellulitis (n=1) and intraparenchymal hematoma (n=1). There was 1 major complication reported, with pleuro-peritoneal fistula causing recurrent large pleural effusion necessitating repeated thoracocentesis (n=1). There was no statistically significant association between tumour size, location or ablation factors, and risk of recurrence or residual disease. A subset analysis identified 6 segment VIII lesions, which were treated via a trans-pleural approach. This cohort demonstrated an overall complication rate of 33% (2/6), including 1 minor complication of asymptomatic pneumothorax and 1 major complication of pleuro-peritoneal fistula. Conclusions: Microwave ablation therapy is an effective and safe treatment option in cases of non-resectable hepatocellular carcinoma and liver metastases, with good local tumour control and low complication rates. A trans-pleural approach for high segment VIII lesions is associated with a higher complication rate and warrants greater caution.Keywords: hepatocellular carcinoma, liver metastases, microwave ablation, trans-pleural approach
Procedia PDF Downloads 1357997 Use of a Chagas Urine Nanoparticle Test (Chunap) to Correlate with Parasitemia Levels in T. cruzi/HIV Co-Infected Patients
Authors: Yagahira E. Castro-Sesquen, Robert H. Gilman, Carolina Mejia, Daniel E. Clark, Jeong Choi, Melissa J. Reimer-Mcatee, Rocio Castro, Jorge Flores, Edward Valencia-Ayala, Faustino Torrico, Ricardo Castillo-Neyra, Lance Liotta, Caryn Bern, Alessandra Luchini
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Early diagnosis of reactivation of Chagas disease in HIV patients could be lifesaving; however, in Latin American the diagnosis is performed by detection of parasitemia by microscopy which lacks sensitivity. To evaluate if levels of T. cruzi antigens in urine determined by Chunap (Chagas urine nanoparticle test) are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. T. cruzi antigens in urine of HIV patients (N=55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. The percentage of Chagas positive patients determined by Chunap compared to blood microscopy, qPCR, and ELISA was 100% (6/6), 95% (18/19) and 74% (23/31), respectively. Chunap specificity was 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels (determined by qPCR) and urine T. cruzi antigen concentrations (p<0.001). A cut-off of > 105 pg was chosen to determine patients with reactivation of Chagas disease (6/6). Urine antigen concentration was significantly higher among patients with CD4+ lymphocyte counts below 200/mL (p=0.045). Chunap shows potential for early detection of reactivation and with appropriate adaptation can be used for monitoring Chagas disease status in T. cruzi/HIV co-infected patients.Keywords: antigenuria, Chagas disease, Chunap, nanoparticles, parasitemia, poly N-isopropylacrylamide (NIPAm)/trypan blue particles (polyNIPAm/TB), reactivation of Chagas disease.
Procedia PDF Downloads 3777996 Assessment of Delirium, It's Possible Risk Factors and Outcome in Patient Admitted in Medical Intensive Care Unit
Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda
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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.Keywords: delirium, risk factors, outcome, intervention
Procedia PDF Downloads 1637995 Pollution Assessment and Potential Ecological Risk of Some Traces Metals in the Surface Sediments of the Gulf of Tunis, North Tunisia
Authors: Haïfa Ben Mna, Ayed Added
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To evaluate the trace metals contamination status in the Gulf of Tunis, forty one sediment samples were analyzed using different approaches. According to certain contamination and ecological risk indices (Contamination Factor, Geoaccumulation index and Ecological risk index), Hg has the highest contamination level while pollution by Ni, Pb, Cd and Cr was absent. The highest concentrations of trace metals were found in sediments collected from the offshore and coastal areas located opposite the main exchange points with the gulf particularly, the Mejerda and Meliane Rivers, the Khalij Channel, Ghar El Melh and El Malah lagoons, Tunis Lake and Sebkhat Ariana. However, further ecological indices (Potential ecological risk index, Toxic unit and Mean effect-range median quotient) and comparison with sediment quality guidelines suggest that in addition to Mercury, Cr, Pb and Ni concentrations are detrimental to biota in both the offshore and areas near to the exchange points with the gulf. Moreover, in these areas the results from sequential extraction and individual contamination factor calculation pointed to the mobility and bioavailability of Cr, Pb and Ni.Keywords: sediment, trace metals, contamination assessment, ecological risk, Tunis gulf
Procedia PDF Downloads 847994 A Field Study of Monochromatic Light Effects on Antibody Responses to Newcastle Disease by HI Test and the Correlation with ELISA
Authors: Seyed Mehrzad Pahlavani, Mozaffar Haji Jafari Anaraki, Sayma Mohammadi
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A total of 34700 day-old broilers were exposed to green, blue and yellow light using a light-emitting diode system for 6 weeks to investigate the effects of light wave length on antibody responses to Newcastle disease by HI test and the correlation with ELISA. 3 poultry house broiler farms with the same conditions was selected and the lightening system of each was set according to the requirement. Blood samples were taken from 20 chicks on days 1, 24 and 46 and the Newcastle virus specific antibody was titered in serum using HI an ELISA test. On day 24, the probability value of more than 0/05 was observed in HI and ELISA tests of all groups while at the end of breeding period, the average HI serum antibody titer was more in the green light than the yellow one while the blue light was not significantly different from both. At the last titration, the green light has got the highest titer of Newcastle antibodies. There were no significant differences of Newcastle antibody titers between all groups and ages in broiler pullets in ELISA. According to the sampling and analysis of HI and ELISA serum tests, there were no significant relationships between all broiler pullets breeding in green, blue and yellow light on days 24 and 46 and the P-value was more than 0/05. It is suggested that the monochromatic light is effective on broilers immunity against Newcastle disease.Keywords: monochromatic light, Newcastle disease, HI test, ELISA test
Procedia PDF Downloads 6577993 Intraoperative ICG-NIR Fluorescence Angiography Visualization of Intestinal Perfusion in Primary Pull-Through for Hirschsprung Disease
Authors: Mohammad Emran, Colton Wayne, Shannon M Koehler, P. Stephen Almond, Haroon Patel
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Purpose: Assessment of anastomotic perfusion in Hirschsprung disease using Indocyanine Green (ICG)-near-infrared (NIR) fluorescence angiography. Introduction: Anastomotic stricture and leak are well-known complications of Hirschsprung pull-through procedures. Complications are due to tension, infection, and/or poor perfusion. While a surgeon can visually determine and control the amount of tension and contamination, assessment of perfusion is subject to surgeon determination. Intraoperative use of ICG-NIR enhances this decision-making process by illustrating perfusion intensity and adequacy in the pulled-through bowel segment. This technique, proven to reduce anastomotic stricture and leak in adults, has not been studied in children to our knowledge. ICG, an FDA approved, nontoxic, non-immunogenic, intravascular (IV) dye, has been used in adults and children for over 60 years, with few side effects. ICG-NIR was used in this report to demonstrate the adequacy of perfusion during transanal pullthrough for Hirschsprung’s disease. Method: 8 patients with Hirschsprung disease were evaluated with ICG-NIR technology. Levels of affected area ranged from sigmoid to total colonic Hirschsprung disease. After leveling, but prior to anastomosis, ICG was administered at 1.25 mg (< 2 mg/kg) and perfusion visualized using an NIR camera, before and during anastomosis. Video and photo imaging was performed and perfusion of the bowel was compared to surrounding tissues. This showed the degree of perfusion and demarcation of perfused and non-perfused bowel. The anastomosis was completed uneventfully and the patients all did well. Results: There were no complications of stricture or leak. 5 of 8 patients (62.5%) had modification of the plan based on ICG-NIR imaging. Conclusion: Technologies that enhance surgeons’ ability to visualize bowel perfusion prior to anastomosis in Hirschsprung’s patients may help reduce post-operative complications. Further studies are needed to assess the potential benefits.Keywords: colonic anastomosis, fluorescence angiography, Hirschsprung disease, pediatric surgery, SPY
Procedia PDF Downloads 1417992 Cardiac Arrest after Cardiac Surgery
Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov
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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients
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