Search results for: waste water treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16338

Search results for: waste water treatment

3798 Pain Management Strategies for Effective Coping with Sickle Cell Disease: The Perspective of Patients in Ghana

Authors: V. A. Adzika, D. Ayim-Aboagye, T. Gordh

Abstract:

Background and aims: Prevalence of Sickle Cell Disease (SCD) is high in Ghana but not much is known in terms of research into non-medical strategies for managing and coping with the pain associated with SCD. This study was carried out to examine effective non-medical related strategies patients use to cope and manage their SCD condition. Methods: SCD patients (387) consisting of 180 males and 204 females between 18-65 years old years participated in the study. A cross-sectional research design was used in which participants completed questionnaires on pain, non-medical coping and management strategies, anxiety, and depression. Results of multiple regression analysis showed that socio-demographic characteristics contributed to the variance in the pain associated with SCD. Results: Over 90% of participants reported that pains associated with SCD were the main reason for seeking treatment in SCD crisis. In terms of non-medical related coping strategies, attending a place of worship and praying were the main coping strategies used in SCD crises, suggesting that patients’ beliefs, particularly in a supernatural being, served as a mitigating factor in the process of coping with the pain associated with SCD crisis. Also, avoidance and withdrawal from people and social activities were reported to be strategies used to cope effectively with the pain associated with SCD crisis. Conclusion: This indicates that it is imperative to incorporate non-medical related coping and management strategies, especially religious beliefs and psychosocial factors, to coping and management of the pain associated with SCD.

Keywords: anxiety, depression, sickle cell disease, quality of life, socio-demographic characteristics, Ghana

Procedia PDF Downloads 385
3797 Determining the Relationship Between Maternal Stress and Depression and Child Obesity: The Mediating Role of Maternal Self-efficacy

Authors: Alireza Monzavi Chaleshtori, Mahnaz Aliakbari Dehkordi, Maryam Aliakbari, Solmaz Seyed Mostafaii

Abstract:

Objective: Considering the growing obesity among children and the role of mother's psychological factors as well as the need to prevent childhood obesity, this study aimed to investigate the mediating role of mother's self-efficacy in the relationship between mother's stress and depression and child obesity. Method: For this purpose, in a descriptive-correlation study, 222 mothers and children aged 1 to 5 years in Tehran, who had the opportunity to answer an online questionnaire, were selected by random sampling and to the depression scales of the Kroenke and Spitzer Patient Health Questionnaire, Cohen's stress and Self-efficacy of Berkeley mothers answered. Pearson correlation test and path analysis were used for data analysis. Findings: The findings showed that maternal depression had an indirect and significant effect on child obesity, and the effect of stress and depression on child obesity was indirect and non-significant. Therefore, the model has a good fit with the research data, and stress and depression indirectly predicted child obesity with the mediating role of self-efficacy. Conclusion: The hypothesized model tested based on mother's stress and depression with the mediating role of mother's self-efficacy was a good model in explaining the prediction of child obesity. Based on the findings of this research, a practical framework can be provided to explain the psychological factors of the mother in relation to child obesity and its treatment.

Keywords: stress, self-efficacy, child obesity, depression

Procedia PDF Downloads 28
3796 Modeling Comfort by Thermal Inertia in Eco-Construction for Low-Income People in an Aqueous Environment in the Face of Sustainable Development in Sub-Saharan Africa; Case of the City of Kinshasa, DR Congo

Authors: Mbambu K. Shaloom, Biba Kalengo, Pierre Echard, Olivier Gilson, Tshiswaka Ngalula, Léonard Kabeya Mukeba Yakasham

Abstract:

In this 21st century, while design and eco-construction continue to be governed by considerations of functionality, safety, comfort and initial investment cost. Today, the principles of sustainable development lead us to think over longer time frames, to take into account new issues and the operating costs of green energy. DR Congo (sub-Saharan Africa) still suffers from the unusability of certain bio-sourced materials (such as bamboo, branches, etc.) and the lack of energy, i.e. 9% of the population has access to electricity and 21% of access to water. Ecoconstruction involves the energy performance of buildings which carry out a dynamic thermal simulation, which targets the different assumptions and conventional parameters (weather, occupancy, materials, thermal comfort, green energies, etc.). The objective of this article is to remedy the thermal, economic and technical artisanal problems in an aqueous environment in the city of Kinshasa. In order to establish a behavioral model to mitigate environmental impacts on architectural modifications and low-cost eco-construction through the approach of innovation and design thinking.

Keywords: thermal comfort, bio-sourced material, eco-architecture, eco-construction, squatting, design thinking

Procedia PDF Downloads 54
3795 Adhesive Based upon Polyvinyl Alcohol And Chemical Modified Oca (Oxalis tuberosa) Starch

Authors: Samantha Borja, Vladimir Valle, Pamela Molina

Abstract:

The development of adhesives from renewable raw materials attracts the attention of the scientific community, due to it promises the reduction of the dependence with materials derived from oil. This work proposes the use of modified 'oca (Oxalis tuberosa)' starch and polyvinyl alcohol (PVA) in the elaboration of adhesives for lignocellulosic substrates. The investigation focused on the formulation of adhesives with 3 different PVA:starch (modified and native) ratios (of 1,0:0,33; 1,0:1,0; 1,0:1,67). The first step to perform it was the chemical modification of starch through acid hydrolysis and a subsequent urea treatment to get carbamate starch. Then, the adhesive obtained was characterized in terms of instantaneous viscosity, Fourier-transform infrared spectroscopy (FTIR) and shear strength. The results showed that viscosity and mechanical tests exhibit data with the same tendency in relation to the native and modified starch concentration. It was observed that the data started to reduce its values to a certain concentration, where the values began to grow. On the other hand, two relevant bands were found in the FTIR spectrogram. The first in 3300 cm⁻¹ of OH group with the same intensity for all the essays and the other one in 2900 cm⁻¹, belonging to the group of alkanes with a different intensity for each adhesive. On the whole, the ratio PVA:starch (1:1) will not favor crosslinking in the adhesive structure and causes the viscosity reduction, whereas, in the others ones, the viscosity is higher. It was also observed that adhesives made with modified starch had better characteristics, but the adhesives with high concentrations of native starch could equal the properties of the adhesives made with low concentrations of modified starch.

Keywords: polyvinyl alcohol, PVA, chemical modification, starch, FTIR, viscosity, shear strength

Procedia PDF Downloads 124
3794 Aerodynamic Study of an Open Window Moving Bus with Passengers

Authors: Pawan Kumar Pant, Bhanu Gupta, S. R. Kale, S. V. Veeravalli

Abstract:

In many countries, buses are the principal means of transport, of which a majority are naturally ventilated with open windows. The design of this ventilation has little scientific basis and to address this problem a study has been undertaken involving both experiments and numerical simulations. The flow pattern inside and around of an open window bus with passengers has been investigated in detail. A full scale three-dimensional numerical simulation has been used for a) a bus with closed windows and b) with open windows. In either simulation, the bus had 58 seated passengers. The bus dimensions used were 2500 mm wide × 2500 mm high (exterior) × 10500 mm long and its speed was set at 40 km/h. In both cases, the flow separates at the top front edge forming a vortex and reattaches close to the mid-length. This attached flow separates once more as it leaves the bus. However, the strength and shape of the vortices at the top front and wake region is different for both cases. The streamline pattern around the bus is also different for the two cases. For the bus with open windows, the dominant airflow inside the bus is from the rear to the front of the bus and air velocity at the face level of the passengers was found to be 1/10th of the free stream velocity. These findings are in good agreement with flow visualization experiments performed in a water channel at 10 m/s, and with smoke/tuft visualizations in a wind tunnel with a free-stream velocity of approximately 40 km/h on a 1:25 scaled Perspex model.

Keywords: air flow, moving bus, open windows, vortex, wind tunnel

Procedia PDF Downloads 201
3793 EEG Neurofeedback Training – Healing the Wounded Brain

Authors: Jamuna Rajeswaran

Abstract:

In the past two decades, with a population of more than a billion. India is passing through a major socio-demographic and epidemiological transition with consequent changes in health scenario. TBI constitute significant burden on health care resources in India The impact on a person and family can be devastating. Patients with TBI experience persistent cognitive deficits, emotional changes, which contribute to the disruption of life activities. The recovery of TBI would be maximized by appropriate rehabilitation. Neurofeedback is an emerging neuroscience-based clinical application. Sixty patients were recruited for this study after obtaining informed consent. Rivermead Head Injury Follow-up Questionnaire, Rivermead Post Concussion Symptoms Questionnaire and Visual Analog Scale were used to assess the behavioral and symptomotolgy associated with post TBI. Neuropsychological assessment was carried out using NIMHANS neuropsychological battery 2004. The Intervention group received neurofeedback training and the waitlist group did not receive any treatment during this phase. Patients were allocated to intervention and waitlist group at random. There were 30 patients in each group. Patients were given 20 sessions of NFT Patients were trained on the O1 and O2 channels for alpha theta training. Each session was of 40 minutes duration with 5-6 sessions per week. The post-training assessment was carried out for the intervention group after 20 sessions of NFT. The waitlist group underwent assessment after one month. Results showed neurofeedback training is effective in ameliorating deficits in cognitive functions and quality of life in patients with TBI. Improvements were corroborated by the clinical interview with patients and significant others post NFT.

Keywords: assessment, rehabilitation, cognition, EEG neurofeedback

Procedia PDF Downloads 244
3792 Effects of Ethanolic Purslane Shoot and Seed Extracts on Doxorubicin-Induced Hepatotoxicity in Albino Rats

Authors: Osama M. Ahmed, Walaa G. Hozayen, Haidy Tamer Abo Sree

Abstract:

Doxorubicin (DOX), an anthracycline antibiotic is a broad-spectrum antineoplastic agent, which is commonly used in the treatment of uterine, ovarian, breast and lung cancers, Hodgkin's disease and soft tissue sarcomas as well as in several other cancer types. The effect of doxorubicin (4 mg/kg b.w.week) without or with oral administration of ethanolic purslane (Portulaca oleracea) shoot (leaves and stems) extract (50 mg/kg b.w. day) or ethanolic purslane seeds extract (50 mg/kg b.w.day) co-treatments for 6 weeks was evaluated in adult male rats. Serum ALT, AST, ALP, GGT, total bilirubin, total protein, and albumin levels were assayed. Lipid peroxidation (indexed by MDA) and antioxidants like hepatic glutathine, glutathione transferase, peroxidase, SOD, and CAT were assessed. There was an increase in serum levels of ALT, AST, ALP, GGT and total bilirubin. In addition, hepatic glutathine, glutathione transferase, peroxidase, SOD, and CAT activities were decreased while lipid peroxidation in the liver was increased. Co-administration of ethanolic purslane and seed extracts successfully improved the adverse changes in the liver functions with an increase in antioxidants activities and reduction of lipid peroxidation. In conclusion, it can be supposed that dietary purslane extract supplementation may provide a cushion for a prolonged therapeutic option against DOX hepatopathy without harmful side effects. However, further clinical studies are required to assess the safety and efficacy of these extract in human beings.

Keywords: doxorubicin, purslane, hepatotoxicity, antioxidants

Procedia PDF Downloads 492
3791 Starch Valorization: Biorefinery Concept for the Circular Bioeconomy

Authors: Maider Gómez Palmero, Ana Carrasco Pérez, Paula de la Sen de la Cruz, Francisco Javier Royo Herrer, Sonia Ascaso Malo

Abstract:

The production of bio-based products for different purposes is one of the strategies that has grown the most at European and even global levels, seeking to contribute to mitigating the impacts associated with climate change and to achieve the ambitious objectives set in this regard. However, the substitution of fossil-based products for bio-based products requires a challenging and deep transformation and adaptation of the secondary and primary sectors and, more specifically, in the latter, the agro-industries. The first step to developing a bio-based value chain focuses on the availability of a resource with the right characteristics for the substitution sought. This, in turn, requires a significant reshaping of the forestry/agricultural sector but also of the agro-industry, which has a relevant potential to be deployed as a supplier and develop a robust logistical supply chain and to market a biobased raw material at a competitive price. However, this transformation may involve a profound restructuring of its traditional business model to incorporate biorefinery concepts. In this sense, agro-industries that generate by-products in their processes that are currently not valorized, such as potato processing rejects or the starch found in washing water, constitute a potential raw material that can be used for different bio-applications. This article aims to explore this potential to evaluate the most suitable bio applications to target and identify opportunities and challenges.

Keywords: starch valorisation, biorefinery, bio-based raw materials, bio-applications

Procedia PDF Downloads 19
3790 CFD Studies on Forced Convection Nanofluid Flow Inside a Circular Conduit

Authors: M. Khalid, W. Rashmi, L. L. Kwan

Abstract:

This work provides an overview on the experimental and numerical simulations of various nanofluids and their flow and heat transfer behavior. It was further extended to study the effect of nanoparticle concentration, fluid flow rates and thermo-physical properties on the heat transfer enhancement of Al2O3/water nanofluid in a turbulent flow circular conduit using ANSYS FLUENT™ 14.0. Single-phase approximation (homogeneous model) and two-phase (mixture and Eulerian) models were used to simulate the nanofluid flow behavior in the 3-D horizontal pipe. The numerical results were further validated with experimental correlations reported in the literature. It was found that heat transfer of nanofluids increases with increasing particle volume concentration and Reynolds number, respectively. Results showed good agreement (~9% deviation) with the experimental correlations, especially for a single-phase model with constant properties. Among two-phase models, mixture model (~14% deviation) showed better prediction compared to Eulerian-dispersed model (~18% deviation) when temperature independent properties were used. Non-drag forces were also employed in the Eulerian two-phase model. However, the two-phase mixture model with temperature dependent nanofluid properties gave slightly closer agreement (~12% deviation).

Keywords: nanofluid, CFD, heat transfer, forced convection, circular conduit

Procedia PDF Downloads 499
3789 Studies on Interaction between Anionic Polymer Sodium Carboxymethylcellulose with Cationic Gemini Surfactants

Authors: M. Kamil, Rahber Husain Khan

Abstract:

In the present study, the Interaction of anionic polymer, sodium carboxymethylcellulose (NaCMC), with cationic gemini surfactants 2,2[(oxybis(ethane-1,2-diyl))bis(oxy)]bis(N-hexadecyl1-N,N-[di(E2)/tri(E3)]methyl1-2-oxoethanaminium)chloride (16-E2-16 and 16-E3-16) and conventional surfactant (CTAC) in aqueous solutions have been studied by surface tension measurement of binary mixtures (0.0- 0.5 wt% NaCMC and 1 mM gemini surfactant/10 mM CTAC solution). Surface tension measurements were used to determine critical aggregation concentration (CAC) and critical micelle concentration (CMC). The maximum surface excess concentration (Ґmax) at the air-water interface was evaluated by the Gibbs adsorption equation. The minimum area per surfactant molecule was evaluated, which indicates the surfactant-polymer Interaction in a mixed system. The effect of changing surfactant chain length on CAC and CMC values of mixed polymer-surfactant systems was examined. From the results, it was found that the gemini surfactant interacts strongly with NaCMC as compared to its corresponding monomeric counterpart CTAC. In these systems, electrostatic interactions predominate. The lowering of surface tension with an increase in the concentration of surfactants is higher in the case of gemini surfactants almost 10-15 times. The measurements indicated that the Interaction between NaCMC-CTAC resulted in complex formation. The volume of coacervate increases with an increase in CTAC concentration; however, above 0.1 wt. % concentration coacervate vanishes.

Keywords: anionic polymer, gemni surfactants, tensiometer, CMC, interaction

Procedia PDF Downloads 61
3788 Colors and Interiority - A Study on the Relationship of Colors and Interior Spaces

Authors: Mahwish Ghulam Rasool

Abstract:

The design of a space is a complex process that involves multiple stages, from conceptualization, identifying design problems to understanding the context, materiality, and functionality of the space. Out of all the design elements, color is one of the most dominant and expressive factors that affect the spatial dynamics of the interior space. Color affects aesthetic comfort in space and has a lasting impact on human perception and psychology. Using color as a tool for creating spatial experiences is a new paradigm. Color semantics in spaces are not only used for surface treatment or aesthetics, but it also has more powerful functional characteristics. As interior spaces are evolving and becoming experiential with each decade, designers are looking for new processes to enhance the spatial and experiential quality of interior spaces. The relationship between color and interior typologies is a relatively new paradigm. This paper discusses the role of colors in interior spaces from various perspectives, exploring their impact on the formation of interior typologies and the use of colors in space design. The paper analyzes interior typologies worldwide, from residential to commercial interior spaces, where color semantics plays a prominent role in the design. The paper also emphasizes the design process and the creation of design language, unveiling the possibilities of applying colors in interior spaces that can be in harmony with the building context, space functionality, or in opposition to the existing building envelope or environment. The paper aims to contribute to the field of interior design education and practices. By using experimental and various research methodologies for investigation, it aims to fill the gap in the literature regarding color semantics and the relationship between interior typologies.

Keywords: color psychology, color semantics, interior environments, interior typologies

Procedia PDF Downloads 50
3787 Stabilisation of a Soft Soil by Alkaline Activation

Authors: Mohammadjavad Yaghoubi, Arul Arulrajah, Mahdi M. Disfani, Suksun Horpibulsuk, Myint W. Bo, Stephen P. Darmawan

Abstract:

This paper investigates the changes in the strength development of a high water content soft soil stabilised with alkaline activation of fly ash (FA) to use in deep soil mixing (DSM) technology. The content of FA was 20% by dry mass of soil, and the alkaline activator was sodium silicate (Na2SiO3). Samples were cured for 3, 7, 14, 28 and 56 days to evaluate the effect of curing time on strength development. To study the effect of adding slag (S) to the mixture on the strength development, 5% S was replaced with FA. In addition, the effect of the initial unit weight of samples on strength development was studied by preparing specimens with two different static compaction stresses. This was to replicate the field conditions where during implementing the DSM technique, the pressure on the soil while being mixed, increases with depth. Unconfined compression strength (UCS), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) tests were conducted on the specimens. The results show that adding S to the FA based geopolymer activated by Na2SiO3 decreases the strength. Furthermore, samples prepared at a higher unit weight demonstrate greater strengths. Moreover, samples prepared at lower unit weight reached their final strength at about 14 days of curing, whereas the strength development continues to 56 days for specimens prepared at a higher unit weight.

Keywords: alkaline activation, curing time, fly ash, geopolymer, slag

Procedia PDF Downloads 314
3786 Design of RF Generator and Its Testing in Heating of Nickel Ferrite Nanoparticles

Authors: D. Suman, M. Venkateshwara Rao

Abstract:

Cancer is a disease caused by an uncontrolled division of abnormal cells in a part of the body, which is affecting millions of people leading to death. Even though there have been tremendous developments taken place over the last few decades the effective therapy for cancer is still not a reality. The existing techniques of cancer therapy are chemotherapy and radio therapy which are having their limitations in terms of the side effects, patient discomfort, radiation hazards and the localization of treatment. This paper describes a novel method for cancer therapy by using RF-hyperthermia application of nanoparticles. We have synthesized ferromagnetic nanoparticles and characterized by using XRD and TEM. These nanoparticles after the biocompatibility studies will be injected in to the body with a suitable tracer element having affinity to the specific tumor site. When RF energy is applied to the nanoparticles at the tumor site it produces heat of excess room temperature and nearly 41-45°C is sufficient to kill the tumor cells. We have designed a RF source generator provided with a temperature feedback controller to control the radiation induced temperature of the tumor site. The temperature control is achieved through a negative feedback mechanism of the thermocouple and a relay connected to the power source of the RF generator. This method has advantages in terms of its effect like localized therapy, less radiation, and no side effects. It has several challenges in designing the RF source provided with coils suitable for the tumour site, biocompatibility of the nanomaterials, cooling system design for the RF coil. If we can overcome these challenges this method will be a huge benefit for the society.

Keywords: hyperthermia, cancer therapy, RF source generator, nanoparticles

Procedia PDF Downloads 440
3785 Synthesis of New Analogs of IPS-339, and Study of Their Cardiovascular in Dogs

Authors: Elham Zarenezhad, Ali Zarenezhad, Mehdi Mardkhoshnood

Abstract:

We described the synthesis and biological study of O-oxime ethers having a-amino acid residues as new analogs of IPS-339. In this synthesis, the reaction of fluorene O-oxime with epichlorohydrin or epibromohydrin afforded the corresponding O-oxime ether adducts. The N-alkylation of valine amino acid with O-oxime ether adducts led to the synthesis of new analogs of IPS-339. The cardiovascular properties of the compound have been studied. In this regard, six clinically healthy same sex mongrel dogs were examined. The dogs were randomly divided into 3 groups of two members. 1 groups received 2 mg kg-1 body weight of compound (2-(3-(9H-fluoren-9-ylideneaminooxy)-2- hydroxypropylamino)-3-methylbutanoic acid) intravenously, whereas group 2 and 3 received only DMSO–water (distil.) and propranolol (Inderal) (2 mg kg-1), respectively. The electrocardiograph (ECG) was recorded with lead II. The recording was run successively by 5 min time interval on each dog before, simultaneously, and after compound infusion. Data after administration were taken from normal sinus beats that were closely related to the arrhythmias whenever they occurred. In general, no detectable arrhythmia was observed in all ECG records regardless of increasing the heart rate that likely caused by stress origin from invasive procedure just after infusion. Compound diminished the heart rate during study especially at 20th minute compared to propranolol as a reference drug. Compound (2-(3-(9H-fluoren-9-ylideneaminooxy)-2- hydroxypropylamino)-3-methylbutanoic acid) was the most effective compound with remarkable ability in declining of the heart rate.

Keywords: electrocardiograph (ECG), cardiovascular, IPS-339, dogs

Procedia PDF Downloads 323
3784 Hemolytic Anemia Monitored After Post-COVID-19 Infection: Changes Related to General Blood Parameters

Authors: Akbarov Elbek Elmurodovich

Abstract:

Introduction: We are analyzing the topic of hemolytic anemia observed in patients after COVID-19 infection. The purpose of this research is to investigate the development of hemolytic anemia, identify its causes, and study treatment methods. Objective and Task: The goal of our research is to analyze the changes in blood occurring after COVID-19 infection and study the development of hemolytic anemia. Our main task is to analyze the results and assess subsequent changes in patients. Materials and Methods: The study was conducted among patients treated with a diagnosis of COVID-19 in the Department of Infectious Diseases at the TTA 1-Multiprofile Clinic from March to August 2023. Out of the 32 patients included, 16 were female, and 16 were male. Monitoring Blood Coagulation in Patients: The hemoglobin level of patients upon admission was initially measured using the URITEST-150 analyzer. The average for women was 110 g/l, and for men was 120 g/l. Over the course of 3 months, a decrease was observed: an average of 72 g/l in women (a decrease of up to 35%) and 84 g/l in men (a decrease of up to 30%). In the next 2 months, the positive dynamics of hemoglobin levels were observed, with an average increase to 93 g/l in women (>28%) and 112 g/l in men (>25%). Research Results: Hemolytic anemia developed in men within 5 months, reaching up to 112 g/l. In women, this process required a longer period, with the last month of observation (6 months) showing that women reached levels of up to 112 g/l, similar to men. Conclusion: Hemolytic anemia observed in patients after COVID-19 infection was monitored for 6 months (5 months in men, 6 months in women), reaching up to 112 g/l. The first 3 months after contracting COVID showed the period of development of anemia, and the subsequent 3 months indicated a stabilization period in patients.

Keywords: COVID, anemia, hemoglobin, tma, virus, viral infrection

Procedia PDF Downloads 38
3783 Antioxidant Face Mask from Purple Sweet Potato (Ipomea Batatas) with Oleum Cytrus

Authors: Lilis Kistriyani, Dine Olisvia, Lutfa Rahmawati

Abstract:

Facial mask is an important part of every beauty treatment because it will give a smooth and gentle effect on the face. This research is done to make edible film that will be applied for face mask. The main ingredient in making this edible film is purple sweet potato powder with the addition of glycerol as plasticizer. One of the ingredients in purple sweet potato is a flavonoid compound. The purpose of this study was to determine the effect of increasing the amount of glycerol to flavonoids release and the effect on the physical properties and biological properties of edible film produced. The stages of this research are the making of edible film, then perform some analysis, among others, spectrophotometer UV-vis analysis to find out how many flavonoids can be released into facial skin, tensile strength and elongation of break analysis, biodegradability analysis, and microbiological analysis. The variation of edible film is the volume of glycerol that is 1 ml, 2 ml, 3 ml. The results of spectrophotometer UV-vis analysis showed that the most flavonoid release concentration is 20.33 ppm in the 2 ml glycerol variation. The best tensile strength value is 8,502 N, and the greatest elongation of break value is 14% in 1 ml glycerol variation. In the biodegradability test, the more volume of glycerol added the faster the edible film is degraded. The results of microbiological analysis showed that purple sweet potato extract has the ability to inhibit the growth of Propionibacterium acnes seen in the presence of inhibiting zone which is 18.9 mm.

Keywords: face mask, edible film, plasticizer, flavonoid

Procedia PDF Downloads 154
3782 A Prospective Study on Alkali Activated Bottom Ash-GGBS Blend in Paver Blocks

Authors: V. Revathi, J. Thaarrini, M. Venkob Rao

Abstract:

This paper presents a study on use of alkali activated bottom ash (BA) and ground granulated blast furnace slag (GGBS) blend in paver blocks. A preliminary effort on alkali-activated bottom ash, blast furnace slag based geopolymer (BA-GGBS-GP) mortar with river sand was carried out to identify the suitable mix for paver block. Several mixes were proposed based on the combination of BA-GGBS. The percentage ratio of BA:GGBS was selected as 100:0, 75:25, 50:50, 25:75 and 0:100 for the source material. Sodium based alkaline activators were used for activation. The molarity of NaOH was considered as 8M. The molar ratio of SiO2 to Na2O was varied from 1 to 4. Two curing mode such as ambient and steam curing 60°C for 24 hours were selected. The properties of paver block such as compressive strength split tensile strength, flexural strength and water absorption were evaluated as per IS15658:2006. Based on the preliminary study on BA-GGBS-GP mortar, the combinations of 25% BA with 75% GGBS mix for M30 and 75% BA with 25% GGBS mix for M35 grade were identified for paver block. Test results shows that the combination of BA-GGBS geopolymer paver blocks attained remarkable compressive strength under steam curing as well as in ambient mode at 3 days. It is noteworthy to know BA-GGBS-GP has promising future in the construction industry.

Keywords: bottom ash, GGBS, alkali activation, paver block

Procedia PDF Downloads 330
3781 Assessment of Land Use and Land Cover Change in Lake Ol Bolossat Catchment, Nyandarua County, Kenya

Authors: John Wangui, Charles Gachene, Stephen Mureithi, Boniface Kiteme

Abstract:

Land use changes caused by demographic, natural variability, economic, technological and policy factors affect the goods and services derived from an ecosystem. In the past few decades, Lake Ol Bolossat catchment in Nyandarua County Kenya has been facing challenges of land cover changes threatening its capacity to perform ecosystems functions and adversely affecting communities and ecosystems downstream. This study assessed land cover changes in the catchment for a period of twenty eight years (from 1986 to 2014). Analysis of three Landsat images i.e. L5 TM 1986, L5 TM 1995 and L8 OLI/TIRS 2014 was done using ERDAS 9.2 software. The results show that dense forest, cropland and area under water increased by 27%, 29% and 3% respectively. On the other hand, open forest, dense grassland, open grassland, bushland and shrubland decreased by 3%, 3%, 11%, 26% and 1% respectively during the period under assessment. The lake was noted to have increased due to siltation caused by soil erosion causing a reduction in Lake’s depth and consequently causing temporary flooding of the wetland. The study concludes that the catchment is under high demographic pressure which would lead to resource use conflicts and therefore formulation of mitigation measures is highly recommended.

Keywords: land cover, land use change, land degradation, Nyandarua, Remote sensing

Procedia PDF Downloads 337
3780 COVID-19: The Cause or the Confounder

Authors: Praveenkumar Natarajan

Abstract:

A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

Procedia PDF Downloads 115
3779 Report of Candida Auris: An Emerging Fungal Pathogen in a Tertiary Healthcare Facility in Ekiti State, Nigeria

Authors: David Oluwole Moses, Odeyemi Adebowale Toba, Olawale Adetunji Kola

Abstract:

Candida auris, an emerging fungus, has been reported in more than 30 countries around the world since its first detection in 2009. Due to its several virulence factors, resistance to antifungals, and persistence in hospital settings, Candida auris has been reported to cause treatment-failure infections. This study was therefore carried out to determine the incidence of Candida auris in a tertiary hospital in Ekiti State, Nigeria. In this study, a total of 115 samples were screened for Candida species using cultural and molecular methods. The carriage of virulence factors and antifungal resistance among C. auris was detected using standard microbiological methods. Candida species isolated from the samples were 15 (30.0%) in clinical samples and 22 (33.85%) in hospital equipment screened. Non-albicans Candida accounted for 3 (20%) and 8 (36.36%) among the isolates from the clinical samples and equipment, respectively. Only five of the non-albicans Candida isolates were C. auris. All the isolates produced biofilm, gelatinase, and hemolysin, while none produced germ tubes. Two of the isolates were resistant to all the antifungals tested. Also, all the isolates were resistant to fluconazole and itraconazole. Nystatin appeared to be the most effective among the tested antifungals. The isolation of Candida auris is being reported for the second time in Nigeria, further confirming that the fungus has spread beyond Lagos and Ibadan, where it was first reported. The extent of the spread of the nosocomial fungus needed to be further investigated and curtailed in Nigeria before its outbreak in healthcare facilities.

Keywords: candida auris, virulence factors, antifungals, pathogen, hospital, infection

Procedia PDF Downloads 21
3778 White-Rot Fungi Phellinus as a Source of Antioxidant and Antitumor Agents

Authors: Yogesh Dalvi, Ruby Varghese, Nibu Varghese, C. K. Krishnan Nair

Abstract:

Introduction: The Genus Phellinus, locally known as Phansomba is a well-known traditional folk medicine. Especially, in Western Ghats of India, many tribes use several species of Phellinus for various ailments related to teeth, throat, tongue, stomach and even wound healing. It is one of the few mushrooms which play a pivotal role in Ayurvedic Dravyaguna. Aim: The present study focuses on to investigate phytochemical analysis, antioxidant, and antitumor (in vitro and in vivo) potential of Phellinus robinae from South India, Kerala Material and Methods: The present study explores the following: 1. Phellinus samples were collected from Ranni, Pathanamthitta district of Kerala state, India from Artocarpus heterophyllus Lam. and species were identified using rDNA region. 2. The fruiting body was shadow dried, powdered and extracted with 50% alcohol using water bath at 60°C which was further condensed by rotary evaporator and lyophilized at minus 40°C temperature. 3. Secondary metabolites were analyzed by using various phytochemical screening assay (Hager’s Test, Wagner’s Test, Sodium hydroxide Test, Lead acetate Test, Ferric chloride Test, Folin-ciocalteu Test, Foaming Test, Benedict’s test, Fehling’s Test and Lowry’s Test). 4. Antioxidant and free radical scavenging activity were analyzed by DPPH, FRAP and Iron chelating assay. 5. The antitumor potential of Water alcohol extract of Phellinus (PAWE) is evaluated through In vitro condition by Trypan blue dye exclusion method in DLA cell line and In vivo by murine model. Result and Discussion: Preliminary phytochemical screening by various biochemical tests revealed presence of a variety of active secondary molecules like alkaloids, flavanoids, saponins, carbohydrate, protein and phenol. In DPPH and FRAP assay PAWE showed significantly higher antioxidant activity as compared to standard Ascorbic acid. While, in Iron chelating assay, PAWE exhibits similar antioxidant activity that of Butylated Hydroxytoluene (BHT) as standard. Further, in the in vitro study, PAWE showed significant inhibition on DLA cell proliferation in dose dependent manner and showed no toxicity on mice splenocytes, when compared to standard chemotherapy drug doxorubicin. In vivo study, oral administration of PAWE showed dose dependent tumor regression in mice and also raised the immunogenicity by restoring levels of antioxidant enzymes in liver and kidney tissue. In both in vitro and in vivo gene expression studies PAWE up-regulates pro-apoptotic genes (Bax, Caspases 3, 8 and 9) and down- regulates anti-apoptotic genes (Bcl2). PAWE also down regulates inflammatory gene (Cox-2) and angiogenic gene (VEGF). Conclusion: Preliminary phytochemical screening revealed that PAWE contains various secondary metabolites which contribute to its antioxidant and free radical scavenging property as evaluated by DPPH, FRAP and Iron chelating assay. PAWE exhibits anti-proliferative activity by the induction of apoptosis through a signaling cascade of death receptor-mediated extrinsic (Caspase8 and Tnf-α), as well as mitochondria-mediated intrinsic (caspase9) and caspase pathways (Caspase3, 8 and 9) and also by regressing angiogenic factor (VEGF) without any inflammation or adverse side effects. Hence, PAWE serve as a potential antioxidant and antitumor agent.

Keywords: antioxidant, antitumor, Dalton lymphoma ascites (DLA), fungi, Phellinus robinae

Procedia PDF Downloads 278
3777 Uptake of Hepatitis B Vaccine among Hepatitis C Positive Patients and Their Vaccine Response in Myanmar

Authors: Zaw Z Aung

Abstract:

Background: High-risk groups for hepatitis B infection (HBV) are people who injected drugs (PWID), men who have sex with men (MSM), people living with HIV (PLHIV) and persons with hepatitis C (HCV), etc. HBV/HCV coinfected patients are at increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. To the best of author’s knowledge, there is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response. Methodology: From February 2018 to May 2018, consented participants at or above 18 years who came to the clinic in Mandalay were tested with the anti-HCV rapid test. Those who tested HCV positive (n=168) were further tested with hepatitis B profile and asked about their previous hepatitis B vaccination history and risk factors. Results: Out of 168 HCV positive participants, three were excluded for active HBV infections. The remaining 165 were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), General Population (GP) monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9). Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 63 participants completed third doses of vaccination (PWID=36, GP=13, HIV/HCV=14). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): HIV/HCV (86%, n=12), PWID (44%, n=16), and GP (46%, n=6) Conclusion: Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, HIV/AIDS and hepatitis C treatment centers is desirable. About half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Keywords: Hepatitis B vaccine, Hepatitis C, HIV, Myanmar

Procedia PDF Downloads 120
3776 The Effect of Rosella Flower Flour (Hibiscus sabdariffa L.) Utilization in Ration on Performance of Broiler Chicken

Authors: Nurlisa Uke Dessy, Dwi Septian Erwinsyah, Zuprizal

Abstract:

This experiment was aimed to investigate the effect of rosella flower flour in diet on broiler chicken Performace. The materials used in this experiment were 72 broiler chickens and were divided into six treatments, those were R0 = without rosella flower flour addition, R1 = 0.5% rosella flower flour addition, R2 = 1.0% rosella flower flour addition, R3 = 1.5% rosella flower flour addition, R4 = 2.0% rosella flower flour addition, and R5 = 2.5% rosella flower flour addition. Each treatment consisted of three replications and each replication consisted of four broiler chickens. This research took 35 days to collect the data. Parameters measured were feed intake, rosella flower flour consumption, body weight gain, feed conversion and mortality. The collected data were analyzed using Completely Randomized Design (CRD) and the differences of mean were tested by Duncan’s New Multiple Range Test (DMRT). The result showed the average of feed consumption were 2154; 2154; 2034; 2154; 2034 and 2154 g/bird on broiler chicken that were feed respectively by 0.0; 0.5; 1.0; 1.5; 2.0; and 2.5% rosella flower flour level. The average consumptions of rosella flower flour respectively were 0; 10.77; 20.34; 32.31; 40.68; and 53.85 g/bird. The body weight gains were 1263.33±70.40; 1422.42±36.33; 1443.75±30.00; 1387.42± 35.30; 1411.17±29.58 and 1457.08±40.75 g/bird. Feed conversion results were 1.71±0.94; 1.51±0.37; 1.47±0.62; 1.55±0.40; 1.53±0.30 and 1.48±0.40. The conclusion of the experiment was known that using rosella flower flour until 2.5% level in diet was able to increase broiler chicken performance, and also to decrease broiler chicken feed conversion.

Keywords: feed intake, consumptions rosella flower flour, broiler chickens, body weight gain, feed conversion

Procedia PDF Downloads 604
3775 Static Characterization of a Bio-Based Sandwich in a Humid Environment

Authors: Zeineb Kesentini, Abderrahim El Mahi, Jean Luc Rebiere, Rachid El Guerjouma, Moez Beyaoui, Mohamed Haddar

Abstract:

Industries’ attention has been drawn to green and sustainable materials as a result of the present energy deficit and environmental damage. Sandwiches formed of auxetic structures made up of periodic cells are also being investigated by industry. Several tests have emphasized the exceptional properties of these materials. In this study, the sandwich's core is a one-cell auxetic core. Among plant fibers, flax fibers are chosen because of their good mechanical properties comparable to those of glass fibers. Poly (lactic acid) (PLA), as a green material, is available from starch, and its production process requires fewer fossil resources than petroleum-based plastics. A polylactic acid (PLA) reinforced with flax fiber filament was employed in this study. The manufacturing process used to manufacture the test specimens is 3D printing. The major drawback of a 100% bio-based material is its low resistance to moisture absorption. In this study, a sandwich based on PLA / flax with an auxetic core is characterized statically for different periods of immersion in water. Bending tests are carried out on the composite sandwich for three immersion time. Results are compared to those of non immersed specimens. It is found that non aged sandwich has the ultimate bending stiffness.

Keywords: auxetic, bending tests, biobased composite, sandwich structure, 3D printing

Procedia PDF Downloads 133
3774 Ethnomedicinal Assets of Plants Collected from Nasarawa State, North Central Nigeria

Authors: Enock E. Goler, Emmanuel H. Kwon-Ndung, Gbenga F. Akomolafe, Terna T. Paul, Markus Musa, Joshua I. Waya, James H. Okogbaa

Abstract:

An ethno-medicinal survey of plants used in treating various diseases and ailments was carried out in the study area of Nasarawa State, North Central Nigeria to obtain information on their uses and potentials. The ethno-medicinal survey was administered through structured questionnaires among local inhabitants from areas with high plant density and diversity within the various Local Government Areas of the State. A total of 84 (Eighty four) plant species belonging to 45 (Forty five) families were found to be useful in treatment of various ailments such as diabetes, measles, fever, asthma, jaundice, pneumonia, sexually transmitted diseases (STDs), aches, diarrhea, cough, arthritis, yellow fever, typhoid, erectile dysfunction and excessive bleeding. Different parts of the plant such as the roots, leaves and stems are used in preparing herbal remedies which could be from dry or freshly collected plants. The main methods of preparation are decoction or infusion, while in some cases the plant parts used are consumed directly. Residents in the study areas find the herbal remedy cheaper and more accessible and claimed that there are no side effects compared to orthodox medicine. This study has confirmed the need towards the conscious conservation of plant genetic resources in order to ensure sustained access to these ethno-medicinal plant materials.

Keywords: ethno-medicinal, Nasarawa, plants, survey

Procedia PDF Downloads 251
3773 An Exploration of Health Promotion Approach to Increase Optimal Complementary Feeding among Pastoral Mothers Having Children between 6 and 23 Months in Dikhil, Djibouti

Authors: Haruka Ando

Abstract:

Undernutrition of children is a critical issue, especially for people in the remote areas of the Republic of Djibouti, since household food insecurity, inadequate child caring and feeding, unhealthy environment and lack of clean water, as well as insufficient maternal and child healthcare, are underlying causes which affect. Nomadic pastoralists living in the Dikhil region (Dikhil) are socio-economically and geographically more vulnerable due to displacement, which in turn worsens the situation of child stunting. A high prevalence of inappropriate complementary feeding among pastoral mothers might be a significant barrier to child growth. This study aims to identify health promotion intervention strategies that would support an increase in optimal complementary feeding among pastoral mothers of children aged 6-23 months in Dikhil. There are four objectives; to explore and to understand the existing practice of complementary feeding among pastoral mothers in Dikhil; to identify the barriers in appropriate complementary feeding among the mothers; to critically explore and analyse the strategies for an increase in complementary feeding among the mothers; to make pragmatic recommendations to address the barriers in Djibouti. This is an in-depth study utilizing a conceptual framework, the behaviour change wheel, to analyse the determinants of complementary feeding and categorize health promotion interventions for increasing optimal complementary feeding among pastoral mothers living in Dikhil. The analytical tool was utilized to appraise the strategies to mitigate the selected barriers against optimal complementary feeding. The data sources were secondary literature from both published and unpublished sources. The literature was systematically collected. The findings of the determinants including the barriers of optimal complementary feeding were identified: heavy household workload, caring for multiple children under five, lack of education, cultural norms and traditional eating habits, lack of husbands' support, poverty and food insecurity, lack of clean water, low media coverage, insufficient health services on complementary feeding, fear, poor personal hygiene, and mothers' low decision-making ability and lack of motivation for food choice. To mitigate selected barriers of optimal complementary feeding, four intervention strategies based on interpersonal communication at the community-level were chosen: scaling up mothers' support groups, nutrition education, grandmother-inclusive approach, and training for complementary feeding counseling. The strategies were appraised through the criteria of effectiveness and feasibility. Scaling up mothers' support groups could be the best approach. Mid-term and long-term recommendations are suggested based on the situation analysis and appraisal of intervention strategies. Mid-term recommendations include complementary feeding promotion interventions are integrated into the healthcare service providing system in Dikhil, and donor agencies advocate and lobby the Ministry of Health Djibouti (MoHD) to increase budgetary allocation on complementary feeding promotion to implement interventions at a community level. Moreover, the recommendations include a community health management team in Dikhil training healthcare workers and mother support groups by using complementary feeding communication guidelines and monitors behaviour change of pastoral mothers and health outcome of their children. Long-term recommendations are the MoHD develops complementary feeding guidelines to cover sector-wide collaboration for multi-sectoral related barriers.

Keywords: Afar, child food, child nutrition, complementary feeding, complementary food, developing countries, Djibouti, East Africa, hard-to-reach areas, Horn of Africa, nomad, pastoral, rural area, Somali, Sub-Saharan Africa

Procedia PDF Downloads 99
3772 Critical Factors in the Formation, Development and Survival of an Eco-Industrial Park: A Systemic Understanding of Industrial Symbiosis

Authors: Iván González, Pablo Andrés Maya, Sebastián Jaén

Abstract:

Eco-industrial parks (EIPs) work as networks for the exchange of by-products, such as materials, water, or energy. This research identifies the relevant factors in the formation of EIPs in different industrial environments around the world. Then an aggregation of these factors is carried out to reduce them from 50 to 17 and classify them according to 5 fundamental axes. Subsequently, the Vester Sensitivity Model (VSM) systemic methodology is used to determine the influence of the 17 factors on an EIP system and the interrelationship between them. The results show that the sequence of effects between factors: Trust and Cooperation → Business Association → Flows → Additional Income represents the “backbone” of the system, being the most significant chain of influences. In addition, the Organizational Culture represents the turning point of the Industrial Symbiosis on which it must act correctly to avoid falling into unsustainable economic development. Finally, the flow of Information should not be lost since it is what feeds trust between the parties, and the latter strengthens the system in the face of individual or global imbalances. This systemic understanding will enable the formulation of pertinent policies by the actors that interact in the formation and permanence of the EIP. In this way, it seeks to promote large-scale sustainable industrial development, integrating various community actors, which in turn will give greater awareness and appropriation of the current importance of sustainability in industrial production.

Keywords: critical factors, eco-industrial park, industrial symbiosis, system methodology

Procedia PDF Downloads 91
3771 Biochemical Assessments of the Effects of Crude Oil Contaminated Diets Wistar Rats

Authors: Olawuyi Sikiru Owolabi

Abstract:

A research was carried out to assess the biochemical effects of crude oil contaminated cat fish on selected rat kidney function tests. Thirty-six (36) albino rats (rattus novergicus) were grouped into six (6) of (6) in each group. The rats in group one served as control and they were placed on feed formulated with catfish cultured in borehole water while those ones from group 2 to group 6 were placed on feed formulated with catfish exposed to various concentrations of crude oil (0.1%,0.25%,0.5%,0.75% and 1% respectively).The results obtained showed that there was a significant increase in serum concentration of creatinine, Urea, sodium and potassium ions in the kidney of experimental rats when compared with the control. This may be interpreted to mean possible adverse effects on the kidney. Several studies have been done especially on the biological effects of crude oil in fish. These include Direct Lethal Toxicity, Sub-Lethal disruption of physiological and behavioral activities, interference with feeding and reproduction, direct coating or tainting of fish, effect of entry of hydrocarbons into the food web as well as alteration of biological habitat. The present study attempts to assess the effects of crude oil contaminated diet on rat kidney by carrying out some kidney function tests like determination of serum sodium and potassium ions by flame photometry method, determination of serum urea and determination of serum creatinine.

Keywords: crude oil, serum urea, creatinine, wistar rats

Procedia PDF Downloads 214
3770 Scanning Electron Microscopy of the Erythrocytes of Channa punctatus (Bloch) Exposed to Mercuric Chloride

Authors: Shweta Maheshwari, Anish Dua

Abstract:

Hematological changes reflect the adverse effects of heavy metals on fish. Hematology is a valuable tool to evaluate pathological condition of the fish. It helps in diagnosing the structural and functional status of fish exposed to toxicants. Morphological alteration in erythrocytes due to environmental stress can be studied through ultra-structural analysis. The aim of the present study was to assess the toxicity of mercuric chloride on red blood cells of an air breathing fish, Channa punctatus. Fish were subjected to chronic experiments using three sublethal concentration of mercuric chloride (0.020mg/L, 0.027mg/L, 0.040mg/L) for a period of 15, 30 and 60 days. Exposed fish of all the three concentrations were subjected to a recovery period of 30 days. A control was maintained in tap water simultaneously. For SEM analysis, blood from caudal vein of fish was taken and examined at an accelerating voltage of 20kV. Scanning electron micrographs revealed elliptical shaped erythrocytes of control fish. Alterations in the erythrocyte morphology such as presence of spherocytes, membrane internalization, crenation of membrane and development of lobopodial projections were observed in the exposed fish. The study revealed that ultra-structural analysis appears to be a sensitive method to evaluate the toxicity of various toxicants to fish.

Keywords: Channa punctatus, erythrocytes, mercuric chloride, scanning electron microscopy

Procedia PDF Downloads 339
3769 Propranalol is Not Effective in Preventing the Progression to Severe Portal Hypertensive Gastropathy in Cirrhotic Patients who Had Undergone Variceal Eradication: A Randomised Controlled Trial

Authors: Jeffey George, Varghese Thomas

Abstract:

Background and Objectives: PHG is an important source of gastrointestinal bleeding in patients with portal hypertension. Aim: To assess the progression to severe portal hypertensive gastropathy(PHG) in patients with cirrhosis who were treated with maximum tolerated dose of propranalol, after variceal eradication to grade II or below. Methods: Cirrhotic patients(child A and B) presenting with upper gastrointestinal bleeding with endoscopic findings of mild or no PHG were followed up over 6 months after variceal eradication to assess the progression to severe PHG. Included patients were randomised to either maximum tolerated doses of propranalol (group A) or to no treatment (group B). Primary end point of the study were the development of gastrointestinal bleed, evidence of hepatic decompensation and death. Progression to severe PHG were compared between the two groups. Results: 56 patients (49 males) were enrolled (group A = 28, group B = 28). 8 patients were excluded from final analysis (gi bleed=5, encephalopathy=2,HCC=1 including 4 deaths).3 patients were lost to follow-up, and 1 developed intolerance to propranalol. Mean dose of propranalol used was 60 mg per day. Progression to severe PHG in the fundus over 6 months was 23.8% in group A versus 15.8 % in group B (p = 0.52). Severe PHG was noted in body in 14.3% in group A versus 21.1% in group B (p = 0.57). 23.8 % in group A had progression to severe PHG compared with 15.8 % in group B (p =0.52). There was no statistically significant difference in the progression of PHG between the two groups(p=0.43). Conclusion: In this short term study propranalol was found not to prevent the progression to severe portal hypertensive gastropathy in cirrhotic patients who had undergone endotherapy for esophageal varices.

Keywords: propranalol, portal hypertensive gastropathy, cirrhotic patients, gastroenterology

Procedia PDF Downloads 321