Search results for: seismic resistance
2779 Methicillin Resistant Staphylococcus aureus Specific Bacteriophage Isolation from Sewage Treatment Plant and in vivo Analysis of Phage Efficiency in Swiss Albino Mice
Authors: Pratibha Goyal, Nupur Mathur, Anuradha Singh
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Antibiotic resistance is the worldwide threat to human health in this century. Excessive use of antibiotic after their discovery in 1940 makes certain bacteria to become resistant against antibiotics. Most common antibiotic-resistant bacteria include Staphylococcus aureus, Salmonella typhi, E.coli, Klebsiella pneumonia, and Streptococcus pneumonia. Among all Staphylococcus resistant strain called Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for several lives threatening infection in human commonly found in the hospital environment. Our study aimed to isolate bacteriophage against MRSA from the hospital sewage treatment plant and to analyze its efficiency In Vivo in Swiss albino mice model. Sewage sample for the isolation of bacteriophages was collected from SDMH hospital sewage treatment plant in Jaipur. Bacteriophages isolated by the use of enrichment technique and after characterization, isolated phages used to determine phage treatment efficiency in mice. Mice model used to check the safety and suitability of phage application in human need which in turn directly support the use of natural bacteriophage rather than synthetic chemical to kill pathogens. Results show the plaque formation in-vitro and recovery of MRSA infected mice during the experiment. Favorable lytic efficiency determination of MRSA and Salmonella presents a natural way to treat lethal infections caused by Multidrug-resistant bacteria by using their natural host-pathogen relationship.Keywords: antibiotic resistance, bacteriophages, methicillin resistance Staphylococcus aureus, pathogens, phage therapy, Salmonella typhi
Procedia PDF Downloads 1452778 Investigating the Impact of the Laundry and Sterilization Process on the Performance of Reusable Surgical Gowns
Authors: N. Khomarloo, F. Mousazadegan, M. Latifi, N. Hemmatinejad
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Recently, the utilization of reusable surgical gowns in order to decrease costs, environmental protection and enhance surgeon’s comfort is considered. One of the concerns in applying this kind of medical protective clothing is reduction of their resistance to bacterial penetration especially in wet state, after repeated laundering and sterilizing process. The purpose of this study is to investigate the effect of the laundering and sterilizing process on the reusable surgical gown’s resistance against bacterial wet penetration. To this end, penetration of Staphylococcus aureus bacteria in wet state after 70 washing and sterilizing cycles was evaluated on the two single-layer and three-layer reusable gowns. The outcomes reveal that up to 20 laundering and sterilizing cycles, protective property of samples improves due to fabric shrinkage, after that because of the fabric’s construction opening, the bacterial penetration increase. However, the three-layer gown presents higher protective performance comparing to the single-layer one.Keywords: laundry, porosity, reusable surgical gown, sterilization, wet bacterial penetration
Procedia PDF Downloads 2792777 Finite Element Analysis of Hollow Structural Shape (HSS) Steel Brace with Infill Reinforcement under Cyclic Loading
Authors: Chui-Hsin Chen, Yu-Ting Chen
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Special concentrically braced frames is one of the seismic load resisting systems, which dissipates seismic energy when bracing members within the frames undergo yielding and buckling while sustaining their axial tension and compression load capacities. Most of the inelastic deformation of a buckling bracing member concentrates in the mid-length region. While experiencing cyclic loading, the region dissipates most of the seismic energy being input into the frame. Such a concentration makes the braces vulnerable to failure modes associated with low-cycle fatigue. In this research, a strategy to improve the cyclic behavior of the conventional steel bracing member is proposed by filling the Hollow Structural Shape (HSS) member with reinforcement. It prevents the local section from concentrating large plastic deformation caused by cyclic loading. The infill helps spread over the plastic hinge region into a wider area hence postpone the initiation of local buckling or even the rupture of the braces. The finite element method is introduced to simulate the complicated bracing member behavior and member-versus-infill interaction under cyclic loading. Fifteen 3-D-element-based models are built by ABAQUS software. The verification of the FEM model is done with unreinforced (UR) HSS bracing members’ cyclic test data and aluminum honeycomb plates’ bending test data. Numerical models include UR and filled HSS bracing members with various compactness ratios based on the specification of AISC-2016 and AISC-1989. The primary variables to be investigated include the relative bending stiffness and the material of the filling reinforcement. The distributions of von Mises stress and equivalent plastic strain (PEEQ) are used as indices to tell the strengths and shortcomings of each model. The result indicates that the change of relative bending stiffness of the infill is much more influential than the change of material in use to increase the energy dissipation capacity. Strengthen the relative bending stiffness of the reinforcement results in additional energy dissipation capacity to the extent of 24% and 46% in model based on AISC-2016 (16-series) and AISC-1989 (89-series), respectively. HSS members with infill show growth in 𝜂Local Buckling, normalized energy cumulated until the happening of local buckling, comparing to UR bracing members. The 89-series infill-reinforced members have more energy dissipation capacity than unreinforced 16-series members by 117% to 166%. The flexural rigidity of infills should be less than 29% and 13% of the member section itself for 16-series and 89-series bracing members accordingly, thereby guaranteeing the spread over of the plastic hinge and the happening of it within the reinforced section. If the parameters are properly configured, the ductility, energy dissipation capacity, and fatigue-life of HSS SCBF bracing members can be improved prominently by the infill-reinforced method.Keywords: special concentrically braced frames, HSS, cyclic loading, infill reinforcement, finite element analysis, PEEQ
Procedia PDF Downloads 952776 Seismic Evaluation of Multi-Plastic Hinge Design Approach on RC Shear Wall-Moment Frame Systems against Near-Field Earthquakes
Authors: Mohsen Tehranizadeh, Mahboobe Forghani
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The impact of higher modes on the seismic response of dual structural system consist of concrete moment-resisting frame and with RC shear walls is investigated against near-field earthquakes in this paper. a 20 stories reinforced concrete shear wall-special moment frame structure is designed in accordance with ASCE7 requirements and The nonlinear model of the structure was performed on OpenSees platform. Nonlinear time history dynamic analysis with 3 near-field records are performed on them. In order to further understand the structural collapse behavior in the near field, the response of the structure at the moment of collapse especially the formation of plastic hinges is explored. The results revealed that the amplification of moment at top of the wall due to higher modes, the plastic hinge can form in the upper part of wall, even when designed and detailed for plastic hinging at the base only (according to ACI code).on the other hand, shear forces in excess of capacity design values can develop due to the contribution of the higher modes of vibration to dynamic response due to the near field can cause brittle shear or sliding failure modes. The past investigation on shear walls clearly shows the dual-hinge design concept is effective at reducing the effects of the second mode of response. An advantage of the concept is that, when combined with capacity design, it can result in relaxation of special reinforcing detailing in large portions of the wall. In this study, to investigate the implications of multi-design approach, 4 models with varies arrangement of hinge plastics at the base and height of the shear wall are considered. results base on time history analysis showed that the dual or multi plastic hinges approach can be useful in order to control the high moment and shear demand of higher mode effect.Keywords: higher mode effect, Near-field earthquake, nonlinear time history analysis, multi plastic hinge design
Procedia PDF Downloads 4312775 Soil Liquefaction Hazard Evaluation for Infrastructure in the New Bejaia Quai, Algeria
Authors: Mohamed Khiatine, Amal Medjnoun, Ramdane Bahar
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The North Algeria is a highly seismic zone, as evidenced by the historical seismicity. During the past two decades, it has experienced several moderate to strong earthquakes. Therefore, the geotechnical engineering problems that involve dynamic loading of soils and soil-structure interaction system requires, in the presence of saturated loose sand formations, liquefaction studies. Bejaia city, located in North-East of Algiers, Algeria, is a part of the alluvial plain which covers an area of approximately 750 hectares. According to the Algerian seismic code, it is classified as moderate seismicity zone. This area had not experienced in the past urban development because of the different hazards identified by hydraulic and geotechnical studies conducted in the region. The low bearing capacity of the soil, its high compressibility and the risk of liquefaction and flooding are among these risks and are a constraint on urbanization. In this area, several cases of structures founded on shallow foundations have suffered damages. Hence, the soils need treatment to reduce the risk. Many field and laboratory investigations, core drilling, pressuremeter test, standard penetration test (SPT), cone penetrometer test (CPT) and geophysical down hole test, were performed in different locations of the area. The major part of the area consists of silty fine sand , sometimes heterogeneous, has not yet reached a sufficient degree of consolidation. The ground water depth changes between 1.5 and 4 m. These investigations show that the liquefaction phenomenon is one of the critical problems for geotechnical engineers and one of the obstacles found in design phase of projects. This paper presents an analysis to evaluate the liquefaction potential, using the empirical methods based on Standard Penetration Test (SPT), Cone Penetration Test (CPT) and shear wave velocity and numerical analysis. These liquefaction assessment procedures indicate that liquefaction can occur to considerable depths in silty sand of harbor zone of Bejaia.Keywords: earthquake, modeling, liquefaction potential, laboratory investigations
Procedia PDF Downloads 3552774 Identification and Antibiotic Susceptibility of Bacteria Isolated from the Intestines of Slaughtered Goat and Cattle
Authors: Latifat Afolake Ogunfolabo, Hakeem Babafemi Ogunfolabo
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The gastrointestinal tract is densely populated with micro-organism which closely and intensively interacts with the host and ingested feed. Food borne infections are some of the major international challenges that lead to high mortality and also, antimicrobial resistance, which has been classified as a serious threat by World Health Organization. Samples of slaughtered cattle and goats intestines were collected and standard culture methods were used for bacteria isolation and identification. Minimum inhibitory concentration of commonly used antibiotic using modification of the disk diffusion method was carried out on isolates. The samples cultured were all positive to Pseudomonas aeruginosa (95% and 90%), Escherichia coli (85%), Salmonella typhi (70% and 60%), Staphylococcus aureus (75%and 100%), Micrococcus luteus (55% and35%), Bacillus macerans (60% and 5%), Bacillus cereus (25% and 20%), Clostridium perfringens (20% and 5%), Micrococcus varians (20% and 5%), Bacillus subtilis (25% and 5%), Streptococcus faecalis (40% and 25%) and Streptococcus faecium (15% and 10%) in goat and cattle respectively. Also, Proteus mirabilis (40%), Micrococcus luteus (35%), Proteus vulgaris (30%), Klebsiella aerogenes(15%) were isolated from cattle. The total coliform (13.55 x10⁵cfu/gm ± 1.77) and (20.30 x10⁵cfu/gm ± 1.27) counts were significantly higher than the total bacteria count (8.3 x10⁵cfu/gm ± 1.41) and (16.60 x10⁵cfu/gm ±0.49) for goat and cattle respectively. Selected Bacteria count of isolates showed that Staphylococcus aureus had the highest significant value (6.9 x10⁵cfu/gm ± 0.57) and (16.80 x10⁵cfu/gm ± 0.57) Escherichia coli (4.60 x10⁵cfu/gm ± 0.42) and (7.05 x10⁵cfu/gm ± 0.64) while the lowest significant value was obtained in Salmonella/Shigella (1.7 x10⁵cfu/gm ± 0.00) and (1.5 x10⁵cfu/gm ± 0.00) for goat and cattle respectively. Susceptibility of bacteria isolated from slaughtered goat and cattle intestine to commonly used antibiotics showed that the highest statistical significant value for zone of inhibition for goat was obtained for Ciprofloxacin (30.00 ± 2.25, 23.75 ± 2.49, 17.17 ± 1.40) followed by Augmentin (28.33 ± 1.22, 21. 83 ± 2.44, 16.67 ± 1.49), Erythromycin (27.75 ±1.48, 20.25 ± 1.29, 16.67 ± 1.26) while the lowest values were obtained for Ofloxacin (27.17 ± 1.89, 21.42 ± 2.19, 16.83 ± 1.26) respectively and values obtained for cattle are Ciprofloxacin (30.64 ± 1.6, 25.79 ± 1.76, 8.07 ± 11.49) followed by Augmentin (28.29 ± 1.33, 22.64 ± 1.82, 17.43 ± 1.55) Ofloxacin (26.57 ± 2.02, 20.79 ± 2.75, 16.21 ± 1.19) while the lowest values were obtained for Erythromycin (26.64 ± 1.49, 20.29 ± 1.49, 16.29 ± 1.33) at different dilution factor (10⁻¹, 10⁻², 10⁻³) respectively. The isolates from goat and cattle were all susceptible to Augmentin at the three different dilution factors. Some goat isolates are intermediate to Ciprofloxacin and Erythromycin at 10⁻² and 10⁻³, while resistance to Ciprofloxacin at 10⁻³ dilution factor. Ciprofloxacin and Ofloxacin at the dilution factors of 10⁻³ and 10⁻¹ for some cattle isolate and resistance were observed for Ofloxacin and Erythromycin at dilution of 10⁻³. These results indicate the susceptibilities and the antimicrobial resistance to commonly used antibiotic.Keywords: antibiotic susceptibility, bacteria, cattle, goat, identification
Procedia PDF Downloads 1272773 Resistance to the South African Root-Knot Nematode Population Densities in Artemisia annua: An Anti-Malaria Ethnomedicinal Plant
Authors: Kgabo Pofu, Hintsa Araya, Dean Oelofse, Sonja Venter, Christian Du Plooy, Phatu Mashela
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Nematode resistance to the tropical root-knot (Meloidogyne species) nematodes is one of the most preferred nematode management strategies in development of smallholder resource-poor farming systems. Due to its pharmacological and ethnomedicinal applications, Artemisia annua is one of the underutilised crops that have attracted attention of policy-makers in rural agrarian development in South Africa. However, the successful introduction of this crop in smallholder resource-poor farming systems could be upset by the widespread aggressive Meloidogyne species, which have limited management options. The objective of this study therefore was to determine the degree of nematode resistance to the South African M. incognita and M. javanica population densities on A. annua seedlings. Uniform three-week-old seedlings in pots containing pasteurised growing medium under greenhouse conditions were inoculated using a series of eggs and second-stage juveniles of two Meloidogyne species in separate trials. At 56 days after inoculation, treatments were highly significant on reproductive factor (RF) for M. incognita and M. javanica on A. annua, contributing 87 and 89% in total treatment variation of the variables, respectively. At all levels of inoculation, RF values for M. incognita (0.17-0.79) and M. javanica (0.02-0.29) were below unity, without any noticeable root galls. Infection of A. annua by both Meloidogyne species had no significant effects on growth variables. In conclusion, A. annua seedlings are resistant to the South African M. incognita and M. javanica population densities and could therefore be explored further for use in smallholder resource-poor farming systems.Keywords: ethnomedicial plants, medicinal plants, underutilised crops, plant parasitic nematodes
Procedia PDF Downloads 3032772 Synthesis of Low-Cost Porous Silicon Carbide Foams from Renewable Sources
Authors: M. A. Bayona, E. M. Cordoba, V. R. Guiza
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Highly porous carbon-based foams are used in a wide range of industrial applications, which include absorption, catalyst supports, thermal insulation, and biomaterials, among others. Particularly, silicon carbide (SiC) based foams have shown exceptional potential for catalyst support applications, due to their chemical inertness, large frontal area, low resistance to flow, low-pressure drop, as well as high resistance to temperature and corrosion. These properties allow the use of SiC foams in harsh environments with high durability. Commonly, SiC foams are fabricated from polysiloxane, SiC powders and phenolic resins, which can be costly or highly toxic to the environment. In this work, we propose a low-cost method for the fabrication of highly porous, three-dimensional SiC foams via template replica, using recycled polymeric sponges as sacrificial templates. A sucrose-based resin combined with a Si-containing pre-ceramic polymer was used as the precursor. Polymeric templates were impregnated with the precursor solution, followed by thermal treatment at 1500 °C under an inert atmosphere. Several synthesis parameters, such as viscosity and composition of the precursor solution (Si: Sucrose molar ratio), and the porosity of the template, were evaluated in terms of their effect on the morphology, composition and mechanical resistance of the resulting SiC foams. The synthesized composite foams exhibited a highly porous (50-90%) and interconnected structure, containing 30-90% SiC with a mechanical compressive strength between 0.01-0.1 MPa. The methodology employed here allowed the fabrication of foams with a varied concentration of SiC and with morphological and mechanical properties that contribute to the development of materials of high relevance in the industry, while using low-cost, renewable sources such as table sugar, and providing a recycling alternative for polymeric sponges.Keywords: catalyst support, polymer replica technique, reticulated porous ceramics, silicon carbide
Procedia PDF Downloads 1272771 Durability of Functionally Graded Concrete
Authors: Prasanna Kumar Acharya, Mausam Kumari Yadav
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Cement concrete has emerged as the most consumed construction material. It has also dominated all other construction materials because of its versatility. Apart from numerous advantages it has a disadvantage concerning durability. The large structures constructed with cement concrete involving the consumption of huge natural materials remain in serviceable condition for 5 – 7 decades only while structures made with stones stand for many centuries. The short life span of structures not only affects the economy but also affects the ecology greatly. As such, the improvement of durability of cement concrete is a global concern and scientists around the globe are trying for this purpose. Functionally graded concrete (FGC) is an exciting development. In contrast to conventional concrete, FGC demonstrates different characteristics depending on its thickness, which enables it to conform to particular structural specifications. The purpose of FGC is to improve the performance and longevity of conventional concrete structures with cutting-edge building materials. By carefully distributing various kinds and amounts of reinforcements, additives, mix designs and/or aggregates throughout the concrete matrix, this variety is produced. A key component of functionally graded concrete's performance is its durability, which affects the material's capacity to tolerate aggressive environmental influences and load-bearing circumstances. This paper reports the durability of FGC made using Portland slag cement (PSC). For this purpose, control concretes (CC) of M20, M30 and M40 grades were designed. Single-layered samples were prepared using each grade of concrete. Further using combinations of M20 + M30, M30 + M40 and M40 + M20, doubled layered concrete samples in a depth ratio of 1:1 was prepared those are herein called FGC samples. The efficiency of FGC samples was compared with that of the higher-grade concrete of parent materials in terms of compressive strength, water absorption, sorptivity, acid resistance, sulphate resistance, chloride resistance and abrasion resistance. The properties were checked at the age of 28 and 91 days. Apart from strength and durability parameters, the microstructure of CC and FGC were studied in terms of X-ray diffraction, scanning electron microscopy and energy-dispersive X-ray. The result of the study revealed that there is an increase in the efficiency of concrete evaluated in terms of strength and durability when it is made functionally graded using a layered technology having different grades of concrete in layers. The results may help to enhance the efficiency of structural concrete and its durability.Keywords: fresh on compacted, functionally graded concrete, acid, chloride, sulphate test, sorptivity, abrasion, water absorption test
Procedia PDF Downloads 222770 Strengthening RC Columns Using Carbon Fiber Reinforced Epoxy Composites Modified with Carbon Nanotubes
Authors: Mohammad R. Irshidat, Mohammed H. Al-Saleh, Mahmoud Al-Shoubaki
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This paper investigates the viability of using carbon fiber reinforced epoxy composites modified with carbon nano tubes to strengthening reinforced concrete (RC) columns. Six RC columns was designed and constructed according to ASCE standards. The columns were wrapped using carbon fiber sheets impregnated with either neat epoxy or CNTs modified epoxy. These columns were then tested under concentric axial loading. Test results show that; compared to the unwrapped specimens; wrapping concrete columns with carbon fiber sheet embedded in CNTs modified epoxy resulted in an increase in its axial load resistance, maximum displacement, and toughness values by 24%, 109% and 232%, respectively. These results reveal that adding CNTs into epoxy resin enhanced the confinement effect, specifically, increased the axial load resistance, maximum displacement, and toughness values by 11%, 6%, and 19%, respectively compared with columns strengthening with carbon fiber sheet embedded in neat epoxy.Keywords: CNT, epoxy, carbon fiber, RC columns
Procedia PDF Downloads 3632769 Spectral Analysis Applied to Variables of Oil Wells Profiling
Authors: Suzana Leitão Russo, Mayara Laysa de Oliveira Silva, José Augusto Andrade Filho, Vitor Hugo Simon
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Currently, seismic methods and prospecting methods are commonly applied in the oil industry and, according to the information reported every day; oil is a source of non-renewable energy. It is easier to understand why the ownership of areas of oil extraction is coveted by many nations. It is necessary to think about ways that will enable the maximization of oil production. The technique of spectral analysis can be used to analyze the behavior of the variables already defined in oil well the profile. The main objective is to verify the series dependence of variables, and to model the variables using the frequency domain to observe the model residuals.Keywords: oil, well, spectral analysis, oil extraction
Procedia PDF Downloads 5362768 Drug Sensitivity Pattern of Organisms Causing Chronic Suppurative Otitis Media
Authors: Fatma M. Benrabha
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The aim of the study was to determine the type and pattern of antibiotic susceptibility of the pathogenic microorganisms causing chronic suppurative otitis media (CSOM), which could lead to better therapeutic decisions and consequently avoidance of appearance of resistance to specific antibiotics. Most frequently isolated agents were Pseudomonas aeruginosa 28.5%; followed by Staphylococcus aureus 18.2%; proteus mirabilis 13.9%; Providencia stuartti 6.7%; Bacteroides melaninogenicus, Aspergillus sp., candida sp., 4.2% each; and other microorganisms were represented in 3-0.2%. Drug sensitivities pattern of Pseudomonas aeruginosa showed that ciprofloxacin was active against the majority of isolates (93.9%) followed by ceftazidime 86.2%, amikacin 76.2% and gentamicin 40.8%. However, Staphylococcus aureus isolates were resistant to penicillin 72.7%, erythromycin 28.6%, cephalothin 18.2%, cloxacillin 8.3% and ciprofloxacin was active against 96.2% of isolates. The resistance pattern of proteus mirabilis were 55.6% to ampicillin, 47.1% to carbencillin, 29.4% to cephalothin, 14.3% to gentamicin and 4.8% to amikacin while 100% were sensitive to ciprofloxacin. We conclude that ciprofloxacin is the best drug of choice in treatment of CSOM caused by the common microorganisms.Keywords: otitis media, chronic suppurative otitis media (CSOM), microorganism, drug sensitivity
Procedia PDF Downloads 4062767 Erosion Wear of Cast Al-Si Alloys
Authors: Pooja Verma, Rajnesh Tyagi, Sunil Mohan
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Al-Si alloys are widely used in various components such as liner-less engine blocks, piston, compressor bodies and pumps for automobile sector and aerospace industries due to their excellent combination of properties like low thermal expansion coefficient, low density, excellent wear resistance, high corrosion resistance, excellent cast ability, and high hardness. The low density and high hardness of primary Si phase results in significant reduction in density and improvement in wear resistance of hypereutectic Al-Si alloys. Keeping in view of the industrial importance of the alloys, hypereutectic Al-Si alloys containing 14, 16, 18 and 20 wt. % of Si were prepared in a resistance furnace using adequate amount of deoxidizer and degasser and their erosion behavior was evaluated by conducting tests at impingement angles of 30°, 60°, and 90° with an erodent discharge rate of 7.5 Hz, pressure 1 bar using erosion test rig. Microstructures of the cast alloys were examined using Optical microscopy (OM) and scanning electron microscopy (SEM) and the presence of Si particles was confirmed by x-ray diffractometer (XRD). The mechanical properties and hardness were measured using uniaxial tension tests at a strain rate of 10-3/s and Vickers hardness tester. Microstructures of the alloys and X-ray examination revealed the presence of primary and eutectic Si particles in the shape of cuboids or polyhedral and finer needles. Yield strength (YS), ultimate tensile strength (UTS), and uniform elongation of the hypereutectic Al-Si alloys were observed to increase with increasing content of Si. The optimal strength and ductility was observed for Al-20 wt. % Si alloy which is significantly higher than the Al-14 wt. % Si alloy. The increased hardness and the strength of the alloys with increasing amount of Si has been attributed presence of Si in the solid solution which creates strain, and this strain interacts with dislocations resulting in solid-solution strengthening. The interactions between distributed primary Si particles and dislocations also provide Orowan strengthening leading to increased strength. The steady state erosion rate was found to decrease with increasing angle of impact as well as Si content for all the alloys except at 900 where it was observed to increase with the increase in the Si content. The minimum erosion rate is observed in Al-20 wt. % Si alloy at 300 and 600 impingement angles because of its higher hardness in comparison to other alloys. However, at 90° impingement angle the wear rate for Al-20 wt. % Si alloy is found to be the minimum due to deformation, subsequent cracking and chipping off material.Keywords: Al-Si alloy, erosion wear, cast alloys, dislocation, strengthening
Procedia PDF Downloads 672766 The Analysis of Drill Bit Optimization by the Application of New Electric Impulse Technology in Shallow Water Absheron Peninsula
Authors: Ayshan Gurbanova
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Despite based on the fact that drill bit which is the smallest part of bottom hole assembly costs only in between 10% and 15% of the total expenses made, they are the first equipment that is in contact with the formation itself. Hence, it is consequential to choose the appropriate type and dimension of drilling bit, which will prevent majority of problems by not demanding many tripping procedure. However, within the advance in technology, it is now seamless to be beneficial in the terms of many concepts such as subsequent time of operation, energy, expenditure, power and so forth. With the intention of applying the method to Azerbaijan, the field of Shallow Water Absheron Peninsula has been suggested, where the mainland has been located 15 km away from the wildcat wells, named as “NKX01”. It has the water depth of 22 m as indicated. In 2015 and 2016, the seismic survey analysis of 2D and 3D have been conducted in contract area as well as onshore shallow water depth locations. With the aim of indicating clear elucidation, soil stability, possible submersible dangerous scenarios, geohazards and bathymetry surveys have been carried out as well. Within the seismic analysis results, the exact location of exploration wells have been determined and along with this, the correct measurement decisions have been made to divide the land into three productive zones. In the term of the method, Electric Impulse Technology (EIT) is based on discharge energies of electricity within the corrosivity in rock. Take it simply, the highest value of voltages could be created in the less range of nano time, where it is sent to the rock through electrodes’ baring as demonstrated below. These electrodes- higher voltage powered and grounded are placed on the formation which could be obscured in liquid. With the design, it is more seamless to drill horizontal well based on the advantage of loose contact of formation. There is also no chance of worn ability as there are no combustion, mechanical power exist. In the case of energy, the usage of conventional drilling accounts for 1000 𝐽/𝑐𝑚3 , where this value accounts for between 100 and 200 𝐽/𝑐𝑚3 in EIT. Last but not the least, from the test analysis, it has been yielded that it achieves the value of ROP more than 2 𝑚/ℎ𝑟 throughout 15 days. Taking everything into consideration, it is such a fact that with the comparison of data analysis, this method is highly applicable to the fields of Azerbaijan.Keywords: drilling, drill bit cost, efficiency, cost
Procedia PDF Downloads 772765 Identification and Characterization of Heavy Metal Resistant Bacteria from the Klip River
Authors: P. Chihomvu, P. Stegmann, M. Pillay
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Pollution of the Klip River has caused microorganisms inhabiting it to develop protective survival mechanisms. This study isolated and characterized the heavy metal resistant bacteria in the Klip River. Water and sediment samples were collected from six sites along the course of the river. The pH, turbidity, salinity, temperature and dissolved oxygen were measured in-situ. The concentrations of six heavy metals (Cd, Cu, Fe, Ni, Pb, and Zn) of the water samples were determined by atomic absorption spectroscopy. Biochemical and antibiotic profiles of the isolates were assessed using the API 20E® and Kirby Bauer Method. Growth studies were carried out using spectrophotometric methods. The isolates were identified using 16SrDNA sequencing. The uppermost part of the Klip River with the lowest pH had the highest levels of heavy metals. Turbidity, salinity and specific conductivity increased measurably at Site 4 (Henley on Klip Weir). MIC tests showed that 16 isolates exhibited high iron and lead resistance. Antibiotic susceptibility tests revealed that the isolates exhibited multi-tolerances to drugs such as tetracycline, ampicillin, and amoxicillin.Keywords: Klip River, heavy metals, resistance, 16SrDNA
Procedia PDF Downloads 3282764 Fracture Toughness Characterizations of Single Edge Notch (SENB) Testing Using DIC System
Authors: Amr Mohamadien, Ali Imanpour, Sylvester Agbo, Nader Yoosef-Ghodsi, Samer Adeeb
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The fracture toughness resistance curve (e.g., J-R curve and crack tip opening displacement (CTOD) or δ-R curve) is important in facilitating strain-based design and integrity assessment of oil and gas pipelines. This paper aims to present laboratory experimental data to characterize the fracture behavior of pipeline steel. The influential parameters associated with the fracture of API 5L X52 pipeline steel, including different initial crack sizes, were experimentally investigated for a single notch edge bend (SENB). A total of 9 small-scale specimens with different crack length to specimen depth ratios were conducted and tested using single edge notch bending (SENB). ASTM E1820 and BS7448 provide testing procedures to construct the fracture resistance curve (Load-CTOD, CTOD-R, or J-R) from test results. However, these procedures are limited by standard specimens’ dimensions, displacement gauges, and calibration curves. To overcome these limitations, this paper presents the use of small-scale specimens and a 3D-digital image correlation (DIC) system to extract the parameters required for fracture toughness estimation. Fracture resistance curve parameters in terms of crack mouth open displacement (CMOD), crack tip opening displacement (CTOD), and crack growth length (∆a) were carried out from test results by utilizing the DIC system, and an improved regression fitting resistance function (CTOD Vs. crack growth), or (J-integral Vs. crack growth) that is dependent on a variety of initial crack sizes was constructed and presented. The obtained results were compared to the available results of the classical physical measurement techniques, and acceptable matchings were observed. Moreover, a case study was implemented to estimate the maximum strain value that initiates the stable crack growth. This might be of interest to developing more accurate strain-based damage models. The results of laboratory testing in this study offer a valuable database to develop and validate damage models that are able to predict crack propagation of pipeline steel, accounting for the influential parameters associated with fracture toughness.Keywords: fracture toughness, crack propagation in pipeline steels, CTOD-R, strain-based damage model
Procedia PDF Downloads 652763 Comfort in Green: Thermal Performance and Comfort Analysis of Sky Garden, SM City, North EDSA, Philippines
Authors: Raul Chavez Jr.
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Green roof's body of knowledge appears to be in its infancy stage in the Philippines. To contribute to its development, this study intends to answer the question: Does the existing green roof in Metro Manila perform well in providing thermal comfort and satisfaction to users? Relatively, this study focuses on thermal sensation and satisfaction of users, surface temperature comparison, weather data comparison of the site (Sky Garden) and local weather station (PAG-ASA), and its thermal resistance capacity. Initially, the researcher conducted a point-in-time survey in parallel with weather data gathering from PAG-ASA and Sky Garden. In line with these, ambient and surface temperature are conducted through the use of a digital anemometer, with humidity and temperature, and non-contact infrared thermometer respectively. Furthermore, to determine the Sky Garden's overall thermal resistance, materials found on site were identified and tabulated based on specified locations. It revealed that the Sky Garden can be considered comfortable based from PMV-PPD Model of ASHRAE Standard 55 having similar results from thermal comfort and thermal satisfaction survey, which is contrary to the actual condition of the Sky Garden by means of a psychrometric chart which falls beyond the contextualized comfort zone. In addition, ground floor benefited the most in terms of lower average ambient temperature and humidity compared to the Sky Garden. Lastly, surface temperature data indicates that the green roof portion obtained the highest average temperature yet performed well in terms of heat resistance compared to other locations. These results provided the researcher valuable baseline information of the actual performance of a certain green roof in Metro Manila that could be vital in locally enhancing the system even further and for future studies.Keywords: Green Roof, Thermal Analysis, Thermal Comfort, Thermal Performance
Procedia PDF Downloads 1722762 The Effects of Xiang Sha Liu Jun Zi Tang to Diarrhea and Growth Performance of Piglets
Authors: Siao-Wei Jiang, Boy-Young Hsieh, Ching-Liang Hsieh, Cheng-Yung Lin
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The problems of multiple drug resistance in the pig farming industry have been emphasized in recent years. Diarrhea syndrome is common in weaning piglets and often treated with antibiotics as a feed additive, leading to the rapid spread of antibiotic resistance and posing high health risks to humans. The study aimed to alleviate diarrhea syndrome with traditional herbal medicine, Xiang Sha Liu Jun Zi Tang, whose effects enhanced digestive function. Piglets at 4 weeks old with stool classified to Bristol stool classification type 6 or type 7 were randomly divided into the control group, group A (1% of Xiang Sha Liu Jun Zi Tang) and group B (0.1% Colistin). The piglets were administrated for 7 days, and their weight, feed intake, and stool score were recorded daily before and after the trial. The results showed that the diarrhea index score in group A and group B improved significantly compared to the control group, indicating that Xiang Sha Liu Jun Zi Tang may have the same effect on alleviating diarrhea syndrome as Colistin, and it may be another replacement for antibiotics.Keywords: pig, diarrhea, herbal medicine, Xiang Sha Liu Jun Zi Tang
Procedia PDF Downloads 532761 Antibiogram and Molecular Characterization of Methicillin-Resistant Staphylococcus Pseudintermedius from Shelter Dogs with Skin Infections and Dog Owners in Abakaliki, Nigeria
Authors: Moses Ikechukwu Benjamin
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The continued increase in methicillin-resistant Staphylococcuspseudintermedius (MRSP) among dogs and the zoonotic transmission event of MRSP from dogs to humans threaten veterinary medicine and public health. The cardinal objective of this study was to determine the antibiogram and frequency of toxingenes in MRSP obtained from shelter dogs with skin infections and dog owners in Abakaliki, Eastern Nigeria. Skinswabs from 61 shelter dogs with skin infections and 33 nasal swabs from dog owners were processed and analyzed using standard microbiological techniques. Susceptibility to antibiotics was determined by Kirby Bauer disc diffusion technique. The screening for Seccanine, lukD, siet, and exitoxin genes was carried out by PCR. A total of 23 (37.7 %) and 1 (3 %) MRSP strains were obtained from shelter dogs and dog owners, respectively. Generally, isolates exhibited high resistance to amoxicillin-clavulanic acid, ceftazidime, and cefepime (100 % - 66.7 %) but were very susceptible (100 % - 70.7 %) to chloramphenicol and doripenem. The only isolate from dog owners harbouredseccanine, lukD, and siet toxin genes while solatesfrom shelter dogs harbouredseccanine16 (69.6 %), lukD 17 (73.9 %), siet 20 (87 %), and exi1 (4.4 %) toxin genes. Isolates were generally observed to be more resistant than other reports from the literature. Interesting, there was a similarity in the resistance antibiotypes and frequency of toxin genes harboured by MRSP isolates between shelter dogs with skin infections and their owner in a sampled household, thus suggesting a likely zoonotic transmission event. This report of the occurrence of MRSP and high frequency of toxin genes (Seccanine,lukD, and siet) in shelter dogs and dog owners represent a major challenge, especially in terms of antibiotic therapy, and is a serious concern for both animal and public health.Keywords: methicillin-resistant S. pseudintermedius, zoonotic transmission, antibiotic resistance, companion dogs, toxin genes
Procedia PDF Downloads 1672760 Experimental Investigation of Heat Transfer and Scale Growth Characteristics of Crystallisation Scale in Agitation Tank
Authors: Prasanjit Das, M .M. K. Khan, M. G. Rasul, Jie Wu, I. Youn
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Crystallisation scale occurs when dissolved minerals precipitate from an aqueous solution. To investigate the crystallisation scale growth of normal solubility salt, a lab-scale agitation tank with and without baffles were used as a benchmark using potassium nitrate as the test fluid. Potassium nitrate (KNO3) solution in this test leads to crystallisation scale on heat transfer surfaces. This experimental investigation has focused on the effect of surface crystallisation of potassium nitrate on the low-temperature heat exchange surfaces on the wall of the agitation tank. The impeller agitation rate affects the scaling rate at the low-temperature agitation wall and it shows a decreasing scaling rate with an increasing agitation rate. It was observed that there was a significant variation of heat transfer coefficients and scaling resistance coefficients with different agitation rate as well as with varying impeller size, tank with and without baffles and solution concentration.Keywords: crystallisation, heat transfer coefficient, scale, resistance
Procedia PDF Downloads 1852759 Effects of Elastic, Plyometric and Strength Training on Selected Anaerobic Factors in Sanandaj Elite Volleyball Players
Authors: Majed Zobairy, Fardin Kalvandi, Kamal Azizbaigi
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This research was carried out for evaluation of elastic, plyometric and resistance training on selected anaerobic factors in men volleyball players. For these reason 30 elite volleyball players of Sanandaj city randomly divided into 3 groups as follow: elastic training, plyometric training and resistance training. Pre-exercise tests which include vertical jumping, 50 yard speed running and scat test were done and data were recorded. Specific exercise protocol regimen was done for each group and then post-exercise tests again were done. Data analysis showed that there were significant increases in exercise test in each group. One way ANOVA analysis showed that increases in speed records in elastic group were significantly higher than the other groups (p<0/05),based on research data it seems that elastic training can be a useful method and new approach in improving functional test and training regimen.Keywords: elastic training, plyometric training, strength training, anaerobic power
Procedia PDF Downloads 5332758 Detection of Resistive Faults in Medium Voltage Overhead Feeders
Authors: Mubarak Suliman, Mohamed Hassan
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Detection of downed conductors occurring with high fault resistance (reaching kilo-ohms) has always been a challenge, especially in countries like Saudi Arabia, on which earth resistivity is very high in general (reaching more than 1000 Ω-meter). The new approaches for the detection of resistive and high impedance faults are based on the analysis of the fault current waveform. These methods are still under research and development, and they are currently lacking security and dependability. The other approach is communication-based solutions which depends on voltage measurement at the end of overhead line branches and communicate the measured signals to substation feeder relay or a central control center. However, such a detection method is costly and depends on the availability of communication medium and infrastructure. The main objective of this research is to utilize the available standard protection schemes to increase the probability of detection of downed conductors occurring with a low magnitude of fault currents and at the same time avoiding unwanted tripping in healthy conditions and feeders. By specifying the operating region of the faulty feeder, use of tripping curve for discrimination between faulty and healthy feeders, and with proper selection of core balance current transformer (CBCT) and voltage transformers with fewer measurement errors, it is possible to set the pick-up of sensitive earth fault current to minimum values of few amps (i.e., Pick-up Settings = 3 A or 4 A, …) for the detection of earth faults with fault resistance more than (1 - 2 kΩ) for 13.8kV overhead network and more than (3-4) kΩ fault resistance in 33kV overhead network. By implementation of the outcomes of this study, the probability of detection of downed conductors is increased by the utilization of existing schemes (i.e., Directional Sensitive Earth Fault Protection).Keywords: sensitive earth fault, zero sequence current, grounded system, resistive fault detection, healthy feeder
Procedia PDF Downloads 1162757 Machine Learning Model to Predict TB Bacteria-Resistant Drugs from TB Isolates
Authors: Rosa Tsegaye Aga, Xuan Jiang, Pavel Vazquez Faci, Siqing Liu, Simon Rayner, Endalkachew Alemu, Markos Abebe
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Tuberculosis (TB) is a major cause of disease globally. In most cases, TB is treatable and curable, but only with the proper treatment. There is a time when drug-resistant TB occurs when bacteria become resistant to the drugs that are used to treat TB. Current strategies to identify drug-resistant TB bacteria are laboratory-based, and it takes a longer time to identify the drug-resistant bacteria and treat the patient accordingly. But machine learning (ML) and data science approaches can offer new approaches to the problem. In this study, we propose to develop an ML-based model to predict the antibiotic resistance phenotypes of TB isolates in minutes and give the right treatment to the patient immediately. The study has been using the whole genome sequence (WGS) of TB isolates as training data that have been extracted from the NCBI repository and contain different countries’ samples to build the ML models. The reason that different countries’ samples have been included is to generalize the large group of TB isolates from different regions in the world. This supports the model to train different behaviors of the TB bacteria and makes the model robust. The model training has been considering three pieces of information that have been extracted from the WGS data to train the model. These are all variants that have been found within the candidate genes (F1), predetermined resistance-associated variants (F2), and only resistance-associated gene information for the particular drug. Two major datasets have been constructed using these three information. F1 and F2 information have been considered as two independent datasets, and the third information is used as a class to label the two datasets. Five machine learning algorithms have been considered to train the model. These are Support Vector Machine (SVM), Random forest (RF), Logistic regression (LR), Gradient Boosting, and Ada boost algorithms. The models have been trained on the datasets F1, F2, and F1F2 that is the F1 and the F2 dataset merged. Additionally, an ensemble approach has been used to train the model. The ensemble approach has been considered to run F1 and F2 datasets on gradient boosting algorithm and use the output as one dataset that is called F1F2 ensemble dataset and train a model using this dataset on the five algorithms. As the experiment shows, the ensemble approach model that has been trained on the Gradient Boosting algorithm outperformed the rest of the models. In conclusion, this study suggests the ensemble approach, that is, the RF + Gradient boosting model, to predict the antibiotic resistance phenotypes of TB isolates by outperforming the rest of the models.Keywords: machine learning, MTB, WGS, drug resistant TB
Procedia PDF Downloads 552756 Health and the Politics of Trust: Multi-Drug-Resistant Tuberculosis in Kathmandu
Authors: Mattia Testuzza
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Public health is a social endeavour, which involves many different actors: from extremely stratified, structured health systems to unofficial networks of people and knowledge. Health and diseases are an intertwined individual and social experiences. Both patients and health workers navigate this public space through relations of trust. Trust in healthcare goes from the personal trust between a patient and her/his doctor to the trust of both the patient and the health worker in the medical knowledge and the healthcare system. Trust it is not a given, but it is continuously negotiated, given and gained. The key to understand these essential relations of trust in health is to recognise them as a social practice, which therefore implies agency and power. In these terms, health is constantly public and made public, as trust emerges as a meaningfully political phenomenon. Trust as a power relation can be observed at play in the implementation of public health policies such as the WHO’s Directly-Observed Theraphy Short-course (DOTS), and with the increasing concern for drug-resistance that tuberculosis pose, looking at the role of trust in the healthcare delivery system and implementation of public health policies becomes significantly relevant. The ethnographic fieldwork was carried out in four months through observation of the daily practices at the National Tuberculosis Center of Nepal, and semi-structured interviews with MultiDrug-Resistant Tuberculosis (MDR-TB) patients at different stages of the treatment, their relatives, MDR-TB specialised nurses, and doctors. Throughout the research, the role which trust plays in tuberculosis treatment emerged as one fundamental ax that cuts through all the different factors intertwined with drug-resistance development, unfolding a tension between the DOTS policy, which undermines trust, and the day-to-day healthcare relations and practices which cannot function without trust. Trust also stands out as a key component of the solutions to unforeseen issues which develop from the overall uncertainty of the context - for example, political instability and extreme poverty - in which tuberculosis treatment is carried out in Nepal.Keywords: trust, tuberculosis, drug-resistance, politics of health
Procedia PDF Downloads 2572755 Liberal Thoughts in the Modern Centuries
Authors: Siavash Soltani Hemmat
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Although 21st-century humanity is at the height of technology and has stepped toward the endless boundaries of knowledge, there are still people in many parts of the world who are deprived of even the most fundamental freedoms. Whereas without freedom, no possible meaning can be imagined for human life, none of the human talents will have the chance to flourish, and that man will be reduced to the level of an animal, removing the obstacles to human freedom, especially from the viewpoint of thoughts, is of utmost importance, in which the liberal ideas of the modern centuries have played an incomparable role. The aim of the present study is to introduce and explain the liberal ideas in the modern centuries and their role in the expansion of human freedoms in order to weaken and discredit the ideological and intellectual barriers to restricting the freedom of individuals and to pave the way for the liberation of humanity. A descriptive method has been employed in order to achieve the objectives of the research. Besides, for data collection, a library method has been conducted. In this study, three ideological teachings of the social contract , resistance against unjust governance and natural law were recognized as the foundations of the realization of fundamental freedoms of the people in the modern centuries and their content was explained and examined.Keywords: freedom, natural law, social contract, resistance
Procedia PDF Downloads 2152754 Properties Modification of Fiber Metal Laminates by Nanofillers
Authors: R. Eslami-Farsani, S. M. S. Mousavi Bafrouyi
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During past decades, increasing demand of modified Fiber Metal Laminates (FMLs) has stimulated a strong trend towards the development of these structures. FMLs contain several thin layers of metal bonded with composite materials. Characteristics of FMLs such as low specific mass, high bearing strength, impact resistance, corrosion resistance and high fatigue life are attractive. Nowadays, increasing development can be observed to promote the properties of polymer-based composites by nanofillers. By dispersing strong, nanofillers in polymer matrix, modified composites can be developed and tailored to individual applications. On the other hand, the synergic effects of nanoparticles such as graphene and carbon nanotube can significantly improve the mechanical, electrical and thermal properties of nanocomposites. In present paper, the modifying of FMLs by nanofillers and the dispersing of nanoparticles in the polymers matrix are discussed. The evaluations have revealed that this approach is acceptable. Finally, a prospect is presented. This paper will lead to further work on these modified FML species.Keywords: fiber metal laminate, nanofiller, polymer matrix, property modification
Procedia PDF Downloads 2062753 Bowing of a Pipeline from Longitudinal Compressive Stress Induced by Ground Movement
Authors: Gennaro Marino
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This paper concerns a case of a 10.75 inch diameter buried gas transmission line which was exposed to mine subsidence ground movements. The pipeline was buried about 4ft. below the surface with maximum operating pressure of 1440 psi. The mine subsidence movement was the result of long walling ore at a depth of approximately 1600 ft. As ore extraction progressed, the stress in the monitored pipeline worsened and was approaching unacceptable levels. The excessive pipe compression resulted when it was exposed to the compression zone of subsidence basin created by mining. The pipe stress reached a significant compressive level due to the extensive length of the pipe exposed to frictional ground-pipe slip resistance. The backfill ground movement slip resistance depends on normal stress around the pipe, the rate of slip, and the backfill characteristics. Normal stress depends on the burial depth of the backfill density and the lateral subsidence induced stress. The backfill in this site has a soil dry density of approximately 90 PCF. A suite of direct shear tests was conducted a residual friction angle of 36 was determined for the ambient backfill. These tests showed that the residual shearing resistance was reached within a fraction of an inch. The pipe was coated with fusion-bonded epoxy, so friction reduce factory of 0.6 can be considered. To relieve ground movement induced compressive stress, the line was uncovered. As more of the pipeline was exposed, the pipe abruptly bowed in the excavation. An analysis of this pipe formation which was performed is provided in this paper. Also discussed in this paper are ways to mitigate this pipe deformation or upheaval buckling from occurring. Keywords: Pipe Upheaval, Pipe Buckling, Ground subsidence, Buried Pipeline, Pipe Stress Mitigation.Keywords: pipe upheaval, pipe buckling, ground subsidence, buried pipeline, pipe stress mitigation
Procedia PDF Downloads 1642752 An Experimental and Numerical Study on the Pultruded GFRP I-Sections Beams
Authors: Parinaz Arashnia, Farzad Hatami, Saeed Ghaffarpour Jahromi
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Using steel in bridges’ construction because of their desired tensile and compressive strength and light weight especially in large spans was widely popular. Disadvantages of steel such as corrosion, buckling and weaknesses in high temperature and unsuitable weld could be solve with using Fibres Reinforced Polymer (FRP) profiles. The FRP is a remarkable class of composite polymers that can improve structural elements behaviour like corrosion resistance, fir resistance with good proofing and electricity and magnetic non-conductor. Nowadays except FRP reinforced bars and laminates, FRP I-beams are made and studied. The main reason for using FRP profiles is, prevent of corrosion and increase the load carrying capacity and durability, especially in large spans in bridges’ deck. In this paper, behaviour of I-section glass fibres reinforced polymer (GFRP) beam is discussed under point loads with numerical models and results has been compared and verified with experimental tests.Keywords: glass fibres reinforced polymer, composite, I-section beam, durability, finite element method, numerical model
Procedia PDF Downloads 2572751 Study of Radiation Response in Lactobacillus Species
Authors: Kanika Arora, Madhu Bala
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The small intestine epithelium is highly sensitive and major targets of ionizing radiation. Radiation causes gastrointestinal toxicity either by direct deposition of energy or indirectly (inflammation or bystander effects) generating free radicals and reactive oxygen species. Oxidative stress generated as a result of radiation causes active inflammation within the intestinal mucosa leading to structural and functional impairment of gut epithelial barrier. As a result, there is a loss of tolerance to normal dietary antigens and commensal flora together with exaggerated response to pathogens. Dysbiosis may therefore thought to play a role in radiation enteropathy and can contribute towards radiation induced bowel toxicity. Lactobacilli residing in the gut shares a long conjoined evolutionary history with their hosts and by doing so these organisms have developed an intimate and complex symbiotic relationships. The objective behind this study was to look for the strains with varying resistance to ionizing radiation and to see whether the niche of the bacteria is playing any role in radiation resistance property of bacteria. In this study, we have isolated the Lactobacillus spp. from probiotic preparation and murine gastrointestinal tract, both of which were supposed to be the important source for its isolation. Biochemical characterization did not show a significant difference in the properties, while a significant preference was observed in carbohydrate utilization capacity by the isolates. Effect of ionizing radiations induced by Co60 gamma radiation (10 Gy) on lactobacilli cells was investigated. A cellular survival curve versus absorbed doses was determined. Radiation resistance studies showed that the response of isolates towards cobalt-60 gamma radiation differs from each other and significant decrease in survival was observed in a dose-dependent manner. Thus the present study revealed that the property of radioresistance in Lactobacillus depends upon the source from where they have been isolated.Keywords: dysbiosis, lactobacillus, mitigation, radiation
Procedia PDF Downloads 1412750 Pediatric Drug Resistance Tuberculosis Pattern, Side Effect Profile and Treatment Outcome: North India Experience
Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant
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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment
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