Search results for: diagnosis and treatment intervals

Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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Authors: Mahmoud M. Tash

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The present study was carried out to investigate the effect of alloying elements and thermo-mechanical treatment (TMT) i.e. hot rolling and forging with different reduction ratios on the hardness (HV) and impact toughness (J) of heat-treated low alloy steels. An understanding of the combined effect of TMT and alloying elements and by measuring hardness, impact toughness, resulting from different heat treatment following TMT of the low alloy steels, it is possible to determine which conditions yielded optimum mechanical properties and high strength to weight ratio. Experimental Correlations between hot work reduction ratio, hardness and impact toughness for thermo-mechanically heat treated low alloy steels are analyzed quantitatively, and both regression and mathematical hardness and impact toughness models are developed.

Keywords: hot forging, hot rolling, heat treatment, hardness (HV), impact toughness (J), microstructure, low alloy steels

Procedia PDF Downloads 509

Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

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Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

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Authors: A. G. Gashua, T. T. Bello, I. Alhassan, K. K. Gwiokura

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Weeds are known to interfere seriously with crop growth, thereby affecting the productivity and quality of crops. Crops are also known to compete for natural growth resources if they are not adequately spaced, also affecting the performance of the growing crop. Farmers grow cowpea in mixtures with cereals and this is known to affect its yield. For this reason, a field experiment was conducted at Yobe State College of Agriculture Gujba, Damaturu station in the 2014 and 2015 rainy seasons to determine the appropriate intra row spacing and weeding regime for optimum growth and yield of cowpea (Vigna unguiculata L.) in pure stand in Sudan Savanna ecology. The treatments consist of three levels of spacing within rows (20 cm, 30 cm and 40 cm) and four weeding regimes (none, once at 3 weeks after sowing (WAS), twice at 3 and 6WAS, thrice at 3WAS, 6WAS and 9WAS); arranged in a Randomized Complete Block Design (RCBD) and replicated three times. The variety used was the local cowpea variety (white, early and spreading) commonly grown by farmers. The growth and yield data were collected and subjected to analysis of variance using SAS software, and the significant means were ranked by Students Newman Keul’s test (SNK). The findings of this study revealed better crop performance in 2015 than in 2014 despite poor soil condition. Intra row spacing significantly influenced vegetative growth especially the number of main branches, leaves and canopy spread at 6WAS and 9WAS with the highest values obtained at wider spacing (40 cm). The values obtained in 2015 doubled those obtained in 2014 in most cases. Spacing also significantly affected the number of pods in 2015, seed weight in both years and grain yield in 2014 with the highest values obtained when the crop was spaced at 30-40 cm. Similarly, weeding regime significantly influenced almost all the growth attributes of cowpea with higher values obtained from where cowpea was weeded three times at 3-week intervals, though statistically similar results were obtained even from where cowpea was weeded twice. Weeding also affected the entire yield and yield components in 2015 with the highest values obtained with increase weeding. Based on these findings, it is recommended that spreading cowpea varieties should be grown at 40 cm (or wider spacing) within rows and be weeded twice at three-week intervals for better crop performance in related ecologies.

Keywords: intra-row spacing, local cowpea, Nigeria, weeding

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Authors: Mardin Abdalqadir, Paul Adzakro, Tannaz Pak, Sina Rezaei Gomari

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Climate change and global warming recently became significant concerns due to the massive emissions of greenhouse gases into the atmosphere, predominantly CO2 gases. Therefore, it is necessary to find sustainable and inexpensive methods to capture the greenhouse gasses and protect the environment for live species. The application of naturally available and cheap adsorbents of carbon such as clay minerals became a great interest. However, the minerals prone to low storage capacity despite their high affinity to adsorb carbon. This paper aims to explore ways to improve the pore volume and surface area of two selected clay minerals, ‘montmorillonite and kaolinite’ by acid treatment to overcome their low storage capacity. Montmorillonite and kaolinite samples were treated with different sulfuric acid concentrations (0.5, 1.2 and 2.5 M) at 40 °C for 8 hours to achieve the above aim. The grain size distribution and morphology of clay minerals before and after acid treatment were explored with Scanning Electron Microscope to evaluate surface area improvement. The ImageJ software was used to find the porosity and pore volume of treated and untreated clay samples. The structure of the clay minerals was also analyzed using an X-ray Diffraction machine. The results showed that the pore volume and surface area were increased substantially through acid treatment, which speeded up the rate of carbon dioxide adsorption. XRD pattern of kaolinite did not change after sulfuric acid treatment, which indicates that acid treatment would not affect the structure of kaolinite. It was also discovered that kaolinite had a higher pore volume and porosity than montmorillonite before and after acid treatment. For example, the pore volume of untreated kaolinite was equal to 30.498 um3 with a porosity of 23.49%. Raising the concentration of acid from 0.5 M to 2.5 M in 8 hours’ time reaction led to increased pore volume from 30.498 um3 to 34.73 um3. The pore volume of raw montmorillonite was equal to 15.610 um3 with a porosity of 12.7%. When the acid concentration was raised from 0.5 M to 2.5 M for the same reaction time, pore volume also increased from 15.610 um3 to 20.538 um3. However, montmorillonite had a higher specific surface area than kaolinite. This study concludes that clay minerals are inexpensive and available material sources to model the realistic conditions and apply the results of carbon capture to prevent global warming, which is one of the most critical and urgent problems in the world.

Keywords: acid treatment, kaolinite, montmorillonite, pore volume, porosity, surface area

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Authors: Fleura Shkëmbi, Sevim Mustafa, Naim Fanaj

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Hypnosis, often known as cognitive therapy, is a sort of mind-body psychotherapy. A professional and certified hypnotist or hypnotherapist guides the patient into this extreme level of focus and relaxation during the session by utilizing verbal cues, repetition, and imagery. In recent years, hypnotherapy has gained popularity in the treatment of a variety of disorders, including anxiety and particular phobias. The term "phobia" is commonly used to define fear of a certain trigger. When faced with potentially hazardous situations, the brain naturally experiences dread. While a little dread here and there may keep us safe, phobias can drastically reduce our quality of life. In summary, persons who suffer from anxiety are considered to see particular environmental situations as dangerous, but those who do not suffer from anxiety do not. Hypnosis is essential in the treatment of anxiety disorders. Hypnosis can help patients minimize their anxiety symptoms. This broad concept has aided in the development of models and therapies for anxiety disorders such as generalized anxiety disorder, panic attacks, hypochondria, and obsessional disorders. Hypnosis techniques are supposed to be attentive and mental pictures, which is conceivable; this is why they're associated with improved working memory and visuospatial abilities. In this sense, the purpose of this study is to determine how effectively specific therapeutic methods perform in treating persons with anxiety and phobias. In addition to cognitive-behavioral therapy and other therapies, the approaches emphasized the use of therapeutic hypnosis. This study looks at the use of hypnosis and related psychotherapy procedures in the treatment of anxiety disorders. Following a discussion of the evolution of hypnosis as a therapeutic tool, neurobiological research is used to demonstrate the influence of hypnosis on the change of perception in the brain. The use of hypnosis in the treatment of phobias, stressful situations, and posttraumatic stress disorder is examined, as well as similarities between the hypnotic state and dissociative reactions to trauma. Through an extensive literature evaluation, this study will introduce hypnotherapy procedures that result in more successful anxiety and phobia treatment.

Keywords: anxiety, hypnosis, hypnotherapy, phobia, technique, state

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Authors: Rahul Kumar, Pavuluri Srinivasa Rao

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This study investigates the effect of ultrasound-assisted high pressure (HP) treatment on the soaking characteristic of soybeans and extracted soy milk quality. The soybean (variety) was subjected to sonication (US) at ambient temperature for 15 and 30 min followed by HP treatment in the range of 200-400 MPa for dwell times 5-10 min. The bean samples were also compared with HPP samples (200-400 MPa; 5-10 mins), overnight soaked samples(12-15 h) and thermal treated samples (100°C/30 min) followed by overnight soaking for 12-15 h soaking. Rapid soaking within 40 min was achieved by the combined US-HPP treatment, and it reduced the soaking time by about 25 times in comparison to overnight soaking or thermal treatment followed by soaking. Reducing the soaking time of soybeans is expected to suppress the development of undesirable beany flavor of soy milk developed during normal soaking milk extraction. The optimum moisture uptake by the sonicated-pressure treated soybeans was 60-62% (w.b) similar to that obtained after overnight soaking for 12-15 h or thermal treatment followed by overnight soaking. pH of soy milk was not much affected by the different US-HPP treatments and overnight soaking which centered around the range of 6.6-6.7 much like the normal cow milk. For milk extracted from thermally treated soy samples, pH reduced to 6.2. Total soluble solids were found to be maximum for the normal overnight soaked soy samples, and it was in the range of 10.3-10.6. For the HPP treated soy milk, the TSS reduced to 7.4 while sonication further reduced it to 6.2. TSS was found to be getting reduced with increasing time of ultrasonication. Further reduction in TSS to 2.3 was observed in soy milk produced from thermally treated samples following overnight soaking. Our results conclude that thermally treated beans' milk is less stable and more acidic, soaking is very rapid compared to overnight soaking hence milk productivity can be enhanced with less development of undesirable beany flavor.

Keywords: beany flavor, high pressure processing, high pressure, soybean, soaking, milk, ultrasound, wet basis

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Authors: Cameron Wilson, Megan Hanrahan, Katie Brittain, Riona McArdle, Alison Keogh, Lynn Rochester

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Background: The loss of mobility and functional dependence is a significant marker in the progression of neurodegenerative diseases such as Parkinson’s Disease (PD). Pharmacological, surgical, and therapeutic treatments are available that can help in the management and amelioration of PD symptoms; however, these only prolong more severe symptoms. Accordingly, ensuring people with PD can maintain independence and a healthy wellbeing are essential in establishing an effective treatment option for those afflicted. Existing literature reviews have examined experiences in engaging with PD treatment options and the impact of PD on independence and wellbeing. Although, the literature fails to explore the influence of treatment options on independence and wellbeing and therefore misses what people value in their treatment. This review is the first that synthesises the impact of mobility-related treatments on independence and wellbeing in people with PD and their carers, offering recommendations to clinical practice and provides a conceptual framework (in development) for future research and practice. Objectives: To explore the impact of mobility-related treatment (both pharmacological and non-pharmacological) on the independence and wellbeing of people with PD and their carers. To propose a conceptual framework to patients, carers and clinicians which captures the qualities people with PD value as part of their treatment. Methods: We performed a critical interpretive synthesis of qualitative evidence, searching six databases for reports that explored the impact of mobility-related treatments (both drug and non-pharmacological) on independence and wellbeing in Parkinson’s Disease. The types of treatments included medication (Levodopa and Amantadine), dance classes, Deep-Brain Stimulation, aquatic therapies, physical rehabilitation, balance training and foetal transplantation. Data was extracted, and quality was assessed using an adapted version of the NICE Quality Appraisal Tool Appendix H before being synthesised according to the critical interpretive synthesis framework and meta-ethnography process. Results: From 2301 records, 28 were eligible. Experiences and impact of treatment pathway on independence and wellbeing was similar across all types of treatments and are described by five inter-related themes: (i) desire to maintain independence, (ii) treatment as a social experience during and after, (iii) medication to strengthen emotional health, (iv) recognising physical capacity and (v) emphasising the personal journey of Parkinson’s treatments. Conclusion: There is a complex and inter-related experience and effect of PD treatments common across all types of treatment. The proposed conceptual framework (in development) provides patients, carers, and clinicians recommendations to personalise the delivery of PD treatment, thereby potentially improving adherence and effectiveness. This work is vital to disseminate as PD treatment transitions from subjective and clinically captured assessments to a more personalised process supplemented using wearable technology.

Keywords: parkinson's disease, medication, treatment, dance, review, healthcare, delivery, levodopa, social, emotional, psychological, personalised healthcare

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Authors: Rajvir Kaur, Jeewani Anupama Ginige

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With recent trends in Big Data and advancements in Information and Communication Technologies, the healthcare industry is at the stage of its transition from clinician oriented to technology oriented. Many people around the world die of cancer because the diagnosis of disease was not done at an early stage. Nowadays, the computational methods in the form of Machine Learning (ML) are used to develop automated decision support systems that can diagnose cancer with high confidence in a timely manner. This paper aims to carry out the comparative evaluation of a selected set of ML classifiers on two existing datasets: breast cancer and cervical cancer. The ML classifiers compared in this study are Decision Tree (DT), Support Vector Machine (SVM), k-Nearest Neighbor (k-NN), Logistic Regression, Ensemble (Bagged Tree) and Artificial Neural Networks (ANN). The evaluation is carried out based on standard evaluation metrics Precision (P), Recall (R), F1-score and Accuracy. The experimental results based on the evaluation metrics show that ANN showed the highest-level accuracy (99.4%) when tested with breast cancer dataset. On the other hand, when these ML classifiers are tested with the cervical cancer dataset, Ensemble (Bagged Tree) technique gave better accuracy (93.1%) in comparison to other classifiers.

Keywords: artificial neural networks, breast cancer, classifiers, cervical cancer, f-score, machine learning, precision, recall

Procedia PDF Downloads 270

Authors: M. Zielina, W. Dabrowski, E. Radziszewska-Zielina

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Several different cements have been tested to evaluate their potential to leach calcium, chromium and aluminum ions in soft water environment. The research allows comparing some different cements in order to the potential risk of water contamination. This can be done only in the same environment. To reach the results in reasonable short time intervals and to make heavy metals measurements with high accuracy, demineralized water was used. In this case the conditions of experiments are far away from the water supply practice, but short time experiments and measurably high concentrations of elements in the water solution are an important advantage. Moreover leaching mechanisms can be recognized, our experiments reported here refer to this kind of cements evaluation.

Keywords: concrete corrosion, hydrogen sulfide, odors, reinforced concrete sewers, sewerage

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Authors: Lidija Simunovic

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A Close-out netting cause is a clause within master agreements which reduces credit risks. This clause contains the parties ' advance agreement that the occurrence of a certain event (such as the commencement of bankruptcy proceedings) will result in the termination of the contract and that their mutual claims will be calculated as a net lump-sum to be paid by one party to the other. The legal treatment of the enforceability of close-out netting clauses opens up many legal matters in comparative legal systems because it is not uniformly treated in comparative laws. Certain legal systems take a liberal approach and allow the enforcement of close-out netting clauses. Others are much stricter, and they limit or completely prohibit the enforcement of close-out netting clauses through the mandatory provisions of their national bankruptcy laws. The author analyzes the concept of close-out netting clauses in selected comparative legal systems and examines the differences in their legal treatment by using the historical, analytical, and comparative method. It results that special treatment of the close-out netting in national laws with a liberal approach is often forced by financial industry lobbies and introduced in national laws without the justified reasons. Contrary to that in legal systems with limited or prohibited approach on close-out netting the uncertain enforceability of the close-out netting clause causes potential credit risks. The detected discrepancy on the national legal treatment and national financial markets regarding close-out netting lead to the conclusion to author’s best knowledge that is not possible to use any national model of close-out netting as a role model which perfectly fits all.

Keywords: close-out netting clauses, derivatives, insolvency, offsetting

Procedia PDF Downloads 141

Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

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Authors: Ligia Florio, João Mauricio Castaldelli-Maia

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Background: Food addiction (FA) emerged in the 1990s as a possible contributor to the increasing prevalence of obesity and overweight, in conjunction with changing food environments and mental health conditions. However, FA is not yet listed as one of the disorders in the DSM-5 and/or the ICD-11. Although there are controversies and debates in the literature about the classification and construct of FA, the most common approach to access it is the use of a research tool - the Yale Food Addiction Scale (YFAS) - which approximates the concept of FA to the concept diagnosis of dependence on psychoactive substances. There is a need to explore the dimensional phenotypes accessed by YFAS in different population groups for a better understanding and scientific support of FA diagnoses. Methods: The primary objective of this project was to investigate the construct validity of the FA concept by mYFAS 2.0 in individuals who underwent bariatric surgery (n = 100) at the Hospital Estadual Mário Covas since 2011. Statistical analyzes were conducted using the STATA software. In this sense, structural or factor validity was the type of construct validity investigated using exploratory factor analysis (EFA) and item response theory (IRT) techniques. Results: EFA showed that the one-dimensional model was the most parsimonious. The IRT showed that all criteria contributed to the latent structure, presenting discrimination values greater than 0.5, with most presenting values greater than 2. Conclusion: This study reinforces a FA dimension in patients who underwent bariatric surgery. Within this dimension, we identified the most severe and discriminating criteria for the diagnosis of FA.

Keywords: obesity, food addiction, bariatric surgery, regain

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Authors: Rayhana Begum, HongBin Wang, Nur Alam Siddiquee, Md.Yasin Ahmed

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Biotin treatment has significant effects on blood glucose, and pharmacological doses of biotin improve hyperglycemia. The present study was aimed to investigate the efficacy and safety of biotin in combination with canagliflozin in improving glycemic control on High Fat Diet-induced diabetes in Rats. Thirty male rats were divided into five groups (six rats /group): control, high fat diet (HFD), canagliflozin (CAG), biotin (BIO), and CAG + BIO. The treatments with CAG and /or BIO significantly reduced the body weight gain, blood glucose and HbA1c levels, whereas CAG in combination with BIO revealed greater glycemic improvement than CAG monotherapy. The treatment with CAG and /or BIO causes significant change in lipid profile and CK level while the treatment with CAG in combination with BIO showed better results as compared with CAG monotherapy. Furthermore, combination of biotin with CAG improved the pancreatic and cardiac damage when compared with other treated groups.

Keywords: canagliflozin, biotin, HbA1c, lipid profile

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Authors: Hyunsik Park

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As the rate of cerebrovascular disease increases in old populations, the prevalence rate of vascular dementia would be expected. Therefore, authors designed this study to find out the possibility of somatosensory evoked potentials(SSEP) as a parameter for early diagnosis and prognosis prediction of vascular dementia in cortical vascular dementia patients. 21 patients who met the criteria for vascular dementia according to DSM-IV,ICD-10and NINDS-AIREN with the history of recent cognitive impairment, fluctuation progression, and neurologic deficit. We subdivided these patients into two groups; a mild dementia and a severe dementia groups by MMSE and CDR score; and analysed comparison between normal control group and patient control group who have been cerebrovascular attack(CVA) history without dementia by using N20 latency and amplitude of median nerve. In this study, mild dementia group showed significant differences on latency and amplitude with normal control group(p-value<0.05) except patient control group(p-value>0.05). Severe dementia group showed significant differences both normal control group and patient control group.(p-value<0.05, <001). Since no significant difference has founded between mild dementia group and patient control group, SSEP has limitation to use for early diagnosis test. However, the comparison between severe dementia group and others showed significant results which indicate SSEP can predict the prognosis of vascular dementia in cortical vascular dementia patients.

Keywords: SSEP, cortical vascular dementia, N20 latency, N20 amplitude

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Authors: Mehravar Javid

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This case study delves into the psychological complexities of a 33-year-old woman, the second of three children, whose upbringing under a critical mother and a high-expectation father has significantly shaped her psychological landscape. Exhibiting a blend of worthlessness and a grandiose self, her life is a constant struggle between idealizing her father and devaluing her mother and sisters, coupled with a fear of intimacy and a desire for merger. This internal conflict manifests in symptoms of depression, anxiety, and a pattern of forming and quitting multiple relationships, all driven by a deep-seated need for validation and approval. The therapeutic journey reveals her resistance to treatment, particularly when her defense mechanisms are challenged, reflecting a complex transference dynamic where she yearns for merger yet fears it. The treatment focuses on empathetically addressing her idealization and mirroring needs, allowing for autonomy while repairing communication gaps. This approach not only confronts her emotional deficits rooted in her family dynamics but also aids in her quest for self-identity, navigating through her feelings of emptiness, inferiority, and powerlessness. The study highlights the nuanced interplay of family influence on the development and maintenance of narcissistic traits, offering insights into the therapeutic strategies that can facilitate growth and self-awareness in similar cases.

Keywords: narcissistic personality disorder, merger transference, treatment interruption, case study, family dynamics

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Authors: Anurag Kumar Pandey, Tapan Kumar Nath, Santanu Dhara

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Polluted water by industrial effluents or dyes has become a major global concern, particularly in developing countries. Such environmental contaminants constitute a serious threat to biodiversity, ecosystems, and human health worldwide; thus, their treatment is critical. The usage of nanoparticles has been discovered to be a potential water treatment method with high efficiency, cheap manufacturing costs, and green synthesis. Carbon dots have attracted the interest of researchers due to their unique properties, such as high water solubility, ease of production, great electron-donating ability, and low toxicity. In this context, we synthesized iodine-doped clove buds-derived carbon dots (I-CCDs) for the Fenton-like degradation of environmental contaminants in water (such as methylene blue (MB) and rhodamine-B (Rh-B) dye). The formation of I-CCDs has been confirmed using various spectroscopy techniques. I-CCDs have demonstrated remarkable optical, cytocompatibility, and antibacterial capabilities. The C-dots that were synthesized were found to be an effective catalyst for the reduction of MB and Rh-B utilizing NaBH4 as a reducing agent. UV-visible spectroscopy was used to construct a detailed pathway for dye reduction step by step. As-prepared I-CCDs have the potential to be a promising solution for wastewater purification and treatment systems.

Keywords: iodine-doped carbon dots, wastewater treatment and purification, environmental friendly, antibacterial

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Authors: Cangir Uyarlar, Eyup Eren Gultepe, Mustafa Kabu, Hacı Ahmet Celik

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This study aimed to evaluate the effects of orally Immunoglobulin (Ig) Y treatments to calves were fed with colostrum having insufficient antibodies before first suckling. A total of 28 Holstein calves were fed assigned into control and treatment groups. The calves were fed fresh colostrum from their respective mother for the first 4 days. The treatment group calves were orally administered IgLock (10 g/d/calf) immediately before the first colostrum feeding and IgLock was administered just one time in treatment group calves. Then, the calves were offered normal milk until weaning. After weaning, all calves kept same paddock and were fed same ration. Diarrhea and respiratoric diseases were recorded for one year. Blood was collected from all calves in the study on birth day (0 day) before vaccination and IgLock administration, then, collected for the following 2 days in all groups. Albumin (ALB), Total Protein (TP), Aspartate Aminotransferase (AST), Alanine Aminotrasferase (ALT), Gamma-Glutamyl Transferase (GGT), Serum Amyloid A (SAA), Haptoglobin (HPT) and Ig G analyses were performed on all samples. Although serum ALB, ALT, GGT and Ig G levels were not shown a time dependent-change within control group; serum TP, AST, HPT and SAA levels were significantly changed by the time within mentioned group. Serum TP level was steady at first 2 days, then, it was increased significantly at 3rd day. Also, serum AST level was significantly increased at 2nd day, then it was descended to first day levels again at 3rd day. Although serum HPT levels were shown a significant gradually decreasing within control group, serum SAA levels were decreased rapidly after first day and there were no significance differences between 2nd and 3rd day in SAA levels. Serum ALB, ALT, HPT and SAA levels were not shown a time dependent-change within treatmet group. After first day Serum TP, GGT, AST and Ig G levels were shown an significant increasing at 2nd day. Serum TP, GGT and Ig G levels were higher as compared to 1st day within treatment group at 3rd day. But, serum AST level was less significantly 3rd day as compared to 2nd day values. The total numbers of calves suffered from diarrhea were significantly less in treatment group as compared to control group (p < 0,05). The pneumonia reappear ratio in calves suffered the diseases is 33,3% in control group and 11,11% in treatment group. Total cost of diseases and additives was 2339,36 $ for control and 1276,4 $ for treatment. As a conclusion, the immunity enhancers like IgLock are important and cost-effective to boost up immunity status in the early age which would be having positive effects on calves were received colostrum included insufficient antibodies.

Keywords: dairy calves, Ig Y, pneumonia, scours

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Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

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Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

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Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

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Authors: Lee Rui, Rajeev Ramachandran

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The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.

Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescent

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Authors: Albana Hasimi, Edlira Tako, Elvin Çomo, Partizan Malkaj, Blerina Papajani, Ledjan Malaj, Mirela Ndrita

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Many endeavors have been exerted during the last years for developing new artificial polymeric membranes which fulfill the demanded conditions for biomedical uses. One of the most tested polymers is Poly(vinyl alcohol) [PVA]. Ours groups, is based on the possibility of using PVA for personal protective equipment against covid. In them, we explore the possibility of modifying the properties of the polymer by adding Montmorillonite [MMT]. Heat-treatment above the glass transition temperature are used to improve mechanical properties mainly by increasing the crystallinity of the polymer, which acts as a physical network. Temperature-Modulated Differential Scanning Calorimetry (TMDSC) measurements indicated that the presence of 0.5% MMT in PVA causes a higher Tg value and shaped peak of crystallinity. Decomposition is observed at two of the melting points of the crystals during heating 25-240oC and overlap of the recrystallization ridges during cooling 240-25oC. This is indicative of the presence of two types (quality or structure ) of polymer crystals. On the other hand, some indication of improvement of the quality of the crystals by heat-treatment is given by the distinct non-reversing contribution to melting. Data on sorption and transport of water in polyvinyl alcohol films: PVA pure and PVA/MMT matrix, modified by thermal treatment, are presented. The thermal treatment has aftereffect the films become more rigid, and because of this, the water uptake is significantly lower in membranes. That is indicates by analysis of the resulting water uptake kinetics. The presence 0.5% w/w of MMT has no significant impact on the properties of PVA membranes. Water uptake kinetics deviates from Fick’s law due to slow relaxation of glassy polymer matrix for all membranes category.

Keywords: crystallinity, montmorillonite, nanocomposite, poly (vinyl alcohol)

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Authors: Barbosa M. L. S., von Ancken A. C. B., Coelho C. P.

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In order to improve the treatment of epileptic dogs, this case report aims toobjective todescribe the use of the homeopathic medicine Cicuta virosa for the treatmentof seizuresin dogs that already use allopathy to control them. Howeach patient presents symptoms individually, the choice of medicationhomeopathic treatment must also be individualized. He was treated in the municipality of RibeirãoPires, São Paulo - Brazil, an animal of the canine species, female, 7 years old, SRD, with a history of seizuregeneralized tonic-clonic for two years, with a variable frequency of 1-2 seizures perday. With no identifiable etiology, the patient used phenobarbital daily, and the dose ofmedication was increased according to the frequency of seizures. The serum concentration of phenobarbital within 12 hours of itsadministration via blood sample was within the range ofreference. The patient experienced weight gain and intermittent sedation. the choice ofhomeopathic medicine Cicuta virosa 6 cH, prepared according to the PharmacopoeiaBrazilian Homeopathic Medicine, occurred due to its characteristic action on the nervous system, especially in epileptic animals that present with seizures, spasmodic contractions of the muscles of the whole body starting from the head, mouth, extremely violent, with rigidity and opisthotonos, extreme agitation, contortionsmultiple. The animal was submitted to treatment with 2 globules orally twicea day for 30 days. The treatment resulted in a clinical cure as there was no moreseizures, being effective to control this symptom.

Keywords: homeopathy, cicuta virosa, epilepsy, veterinary medicine

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Authors: Saad Chahba, Rabia Sehab, Ahmad Akrad, Cristina Morel

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Nowadays, the electric machines used in urban electric vehicles are, in most cases, three-phase electric machines with or without a magnet in the rotor. Permanent Magnet Synchronous Machine (PMSM) and Induction Machine (IM) are the main components of drive trains of electric and hybrid vehicles. These machines have very good performance in healthy operation mode, but they are not redundant to ensure safety in faulty operation mode. Faced with the continued growth in the demand for electric vehicles in the automotive market, improving the reliability of electric vehicles is necessary over the lifecycle of the electric vehicle. Multiphase electric machines respond well to this constraint because, on the one hand, they have better robustness in the event of a breakdown (opening of a phase, opening of an arm of the power stage, intern-turn short circuit) and, on the other hand, better power density. In this work, a diagnosis approach using a neural network for an open circuit fault or more of a five-phase induction machine is developed. Validation on the simulator of the vehicle drivetrain, at reduced power, is carried out, creating one and more open circuit stator phases showing the efficiency and the reliability of the new approach to detect and to locate on-line one or more open phases of a five-induction machine.

Keywords: electric vehicle drivetrain, multiphase drives, induction machine, control, open circuit (OC) fault diagnosis, artificial neural network

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Authors: Ayman M. El-Zahaby, Ahmed S. El-Gendy

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Aeration for wastewater is essential for the proper operation of aerobic treatment units where the wastewater normally has zero dissolved oxygen. This is due to the need of oxygen by the aerobic microorganisms to grow and survive. Typical aeration units for wastewater treatment require electric energy for their operation such as mechanical aerators or diffused aerators. The passive units are units that operate without the need of electric energy such as cascade aerators, spray aerators and tray aerators. In contrary to the cascade aerators and spray aerators, tray aerators require much smaller area foot print for their installation as the treatment stages are arranged vertically. To the extent of the authors knowledge, the design of tray aerators for the aeration purpose has not been presented in the literature. The current research concerns with an analytical study for the design of tray aerators for the purpose of increasing the dissolved oxygen in wastewater treatment systems, including an investigation on different design parameters and their impact on the aeration efficiency. The studied aerator shall act as an intermediate stage between an anaerobic primary treatment unit and an aerobic treatment unit for small scale treatment systems. Different free falling flow regimes were investigated, and the thresholds for transition between regimes were obtained from the literature. The study focused on the jetting flow regime between trays. Starting from the two film theory, an equation that relates the dissolved oxygen concentration effluent from the system was derived as a function of the flow rate, number of trays, tray area, spacing between trays, number and diameter of holes and the water temperature. A MATLab ® model was developed for the derived equation. The expected aeration efficiency under different tray configurations and operating conditions were illustrated through running the model with varying the design parameters. The impact of each parameter was illustrated. The overall system efficiency was found to increase by decreasing the hole diameter. On the other side, increasing the number of trays, tray area, flow rate per hole or tray spacing had positive effect on the system efficiency.

Keywords: aeration, analytical, passive, wastewater

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Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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Authors: Phatu William Mashela, Pontsho Edmund Tseke, Kgabo Martha Pofu

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‘Inconsistent results’ in nematode suppression post-application of botanical-based products created credibility concerns. Relative to untreated control, sampling for nematodes post-application of botanical-based products suggested significant increases in nematode population densities. ‘Inconsistent results’ were confirmed in Tylenchulus semipenetrans on Citrus jambhiri seedlings when sampling was carried out at 120 days post-application of a granular Nemarioc-AG phytonematicide. The objective of this study was to determine post-application effects of untreated control, Nemarioc-AG phytonematicide and aldicarb to T. semipenetrans population densities on C. jambhiri seedlings. Two hundred and ten seedlings were each inoculated with 10000 T. semipenetrans eggs and second-stage juveniles (J2) in plastic pots containing 2700 ml growing mixture. A week after inoculation, seedlings were equally split and subjected to once-off treatment of 2 g aldicarb, 2 g Nemarioc-AG phytonematicide and untreated control. Five seedlings from each group were randomly placed on greenhouse benches to serve as a sampling block, with a total of 14 blocks. The entire block was sampled weekly and assessed for final nematode population density (Pf). After the final assessment, post-regression of untreated Pf to increasing sampling intervals exhibited positive quadratic relations, with the model explaining 90% associations, with optimum Pf of 13804 eggs and J2 at six weeks post-application. In contrast, treated Pf and increasing sampling interval exhibited negative quadratic relations, with the model explaining 95% and 92% associations in phytonematicide and aldicarb, respectively. In the phytonematicide, Pf was 974 eggs and J2, whereas that in aldicarb was 2205 eggs and J2 at six weeks. In conclusion, temporal cyclic nematode population growth provided an empirically-based explanation of ‘inconsistent results’ in nematode suppression post-application of the two nematode management strategies.

Keywords: nematode management, residual effect, slow decline of citrus, the citrus nematode

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Authors: Jose Hernandez, Lina Martínez, Gustavo Gonzalez, Carlos Lázaro, Diana Castrillon, Jonathan Cardona, Laura Mejía, Yina Sanchez, Luisa Ochoa, Evert Jimenez

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Objectives: Economic analyses of tuberculosis control interventions are usually focused on the payer’s perspective. To assess the overall economic impact of the disease, out-of-pocket and indirect costs are also required. This research is aimed to estimate overall economic impact under DOTS-strategy (Directly Observed Therapy Short Course). Methods: A cross-sectional survey of 91 adult tuberculosis patients in treatment for at least two months was conducted from the society perspective. A standardized questionnaire was used in three different cities of Colombia: Medellin (poverty is 17.7%), Monteria (poverty is 36.9%) and Quibdó (poverty is 51.2%). Costs were converted to 2013 USD and categorized into two periods: diagnostics phase and treatment. Results: The median cost during diagnostics was 13$ (±SD 9.5). The median monthly patient out-of-pocket costs during treatment were 32$ (±SD 6.8), equivalent to 17% of patient’s median monthly income, estimated in 186$ (±SD 23). Costs recorded in Medellin were 47$ in Monteria was 18$ and in Quibdó was 13$. Conclusion: Patient costs under DOTS strategy are high even when services are provided free of charge. The creation or strengthening of community-based treatment supervisors could greatly impact costs of tuberculosis and lower drop-outs.

Keywords: tuberculosis, costs and cost analysis, health promotion, Colombia

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Authors: Abu Salim Mustafa

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The comparisons of mycobacterial genomes have identified several Mycobacterium tuberculosis-specific genomic regions that are absent in other mycobacteria and are known as regions of differences. Due to M. tuberculosis-specificity, the peptides encoded by these regions could be useful in the specific diagnosis of tuberculosis. To explore this possibility, overlapping synthetic peptides corresponding to 39 proteins predicted to be encoded by genes present in regions of differences were tested for antibody-reactivity with sera from tuberculosis patients and healthy subjects. The results identified four immunodominant peptides corresponding to four different proteins, with three of the peptides showing significantly stronger antibody reactivity and rate of positivity with sera from tuberculosis patients than healthy subjects. The fourth peptide was recognized equally well by the sera of tuberculosis patients as well as healthy subjects. Predication of antibody epitopes by bioinformatics analyses using ABCpred server predicted multiple linear epitopes in each peptide. Furthermore, peptide sequence analysis for sequence identity using BLAST suggested M. tuberculosis-specificity for the three peptides that had preferential reactivity with sera from tuberculosis patients, but the peptide with equal reactivity with sera of TB patients and healthy subjects showed significant identity with sequences present in nob-tuberculous mycobacteria. The three identified M. tuberculosis-specific immunodominant peptides may be useful in the serological diagnosis of tuberculosis.

Keywords: genomic regions of differences, Mycobacterium tuberculossis, peptides, serodiagnosis

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Authors: Marie Lesly Fontin, Audalbert Bien-Aimé, Didier Marlier, Yves Beckers

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Fecal digestibility of mature plantain leaves was determined in castrated Creolegoatsin order to better assess them. Five diets made from plantain leaves were used in an in vivo digestibility study on 20 castrated Creole goats over three periods using a completely random design in order to assess their apparent fecal digestibility (Dg). These diets consisted of sun-dried leaves (DL), sun-dried urea treated leaves (DUTL, 5kg of urea per 100kg of raw product ensilaged during 90 days with 60 kg of water), sun-dried leaves + hoopvine (Trichostigma octandrum, L)(DLH, DL: 61.4% + Hoopvine: 38.6%), sun-dried leaves + urea (DLU, DL: 98.2%+ U: 1.8%), and fresh leaves. (FL).0.5% of salt diluted with water was added to diets before distribution to the goats. A mineral lick block was available for each goat in its digestibility cage. During each period, diets were distributed to meet the maintenance needs of the goats for 21 days, including 14 days of adaptation and 7 days of measurement. Offered and refused diets and feces were weighed every day, and samples were taken for laboratory analysis. Results showed that the urea treatment increasedCP (Crude Protein) content of DL by 44% (from 10.4% for DL to 15.0% for DUTL) and decreased their NDF (Neutral Detergent Fiber) content (55.5% to 52.4%). Large amounts of refused feed (around 40%) were observed in goats fed with FL, DLU, and DL diets, for which no significant difference was observed for DM (Dry Matter) intakes (40.3; 36.6 and 35.1g/kg0.75 respectively) (p>0.05). DM intakes of DUTL (59.9 g/kg0.75) were significantly (p<0.05) greater than DLH (50.2 g/kg0.75). DM Dg of DL was very low (29.2%). However, supplementation with hoopvine and urea treatment resulted in a significant increase of DM Dg (40.3% and 42.1%, respectively), but the addition of urea (DLU) had no effect on it. FL showed a DM Dg similar to DHL and DUTL diets (39.0%). OM (Organic Matter)Dg was higher for the DUTL diet (45.1%), followed by DLH (40.9%), then by DLU and FL (32.9% and 40.7% respectively) and finally by DL (29.8%). CP Dg was higher for the FL diet (65.7%) and lower for the DL diet (39.9%). NDF Dg was also increased with urea treatment (54.8% for DUTL) and with the addition of hoopvine (41.4%) compared to the DL diet (31.0% for DLH). In conclusion, urea treatment and complementation with hoopvine of plantain leaves are the best treatments among those tested for increasing the nutritive value of this foragein the castrated Creole goats.

Keywords: apparent fecal digestibility, nitrogen supplements, plantain leaves, urea treatment

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