Search results for: glycogen storage disease
4285 Vegetative Materia Medica for the Women Illness in mss2999 Kitab Tibb: A Modern Medical Interpretation of a Malay Medical Manuscript
Authors: Wan Aminah Hasbullah
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The knowledge of medicine in Malay society stemmed out from the need to remedy disease process. Such knowledge came from observations by looking at the signs on the plants which signify it uses, the doctrine of signature, and also observing what kind of animal and its parts that can be used to treat the disease. Prayers (jampi and doa’) play a very important role in the therapeutic processes addressing the ethereal part of the body. In Malay medicine, prayers were said in the heart of the Malay bomoh (medicine man) when they are first approaching the diseased person, seeking the help of Allah in accurately directing his mind into making the right diagnosis and subsequently the right choice of treatment. In the making of medicine, similar rituals were religiously followed, starting from gathering the materia medica to the final concoction of the medicine. Thus, all the materia medica and the prayers in Malay medicine were gathered and documented in the medical manuscript known as MSS 2999 Kitab Tibb. For this study, a collection of vegetative materia medica which is specialized for the women illness from this manuscript will be gathered and analysed. A medical and cultural interpretation will be highlighted to see the relationship between efficacy in traditional Malay medicine as practiced in the past and the recent practice of the modern medicine.Keywords: vegetative, materia medica, woman illness, Malay medical manuscript
Procedia PDF Downloads 2524284 Accepting the Illness and Moving toward Normality: Providing Continuous Care to a Patient by Utilizing Community Mental Health Nursing Skills
Authors: Szu-Yi Chang, Jiin-Ru Rong
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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management
Procedia PDF Downloads 2784283 To Evaluate the Function of Cardiac Viability After Administration of I131
Authors: Baburao Ganpat Apte, Gajodhar
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Introduction: diopathic Parkinson’s disease (PD) is the most common neurodegenerative disorder. Early PD may present a diagnostic challenge with broad differential diagnoses that are not associated with striatal dopamine deficiency. This test was performed by using special type of radioactive precursor which was made available through our logistics. 131I-TOPA L-6-[131I] Iodo-3,4-Trihydroxyphenylalnine (131I -TOPA) is a positron emission tomography (PET) agent that measures the uptake of dopamine precursors for assessment of presynaptic dopaminergic integrity and has been shown to accurately reflect the sign of nervous mind going in patients suffers from monoaminergic disturbances in PD. Both qualitative and quantitative analyses of the scans were performed. Therefore, the early clinical diagnosis alone may be accurate and this reinforces the importance of functional imaging targeting the patholigically of the disease process. The patient’s medical records were then assessed for length of follow-up, response to levotopa, clinical course of sickness, and usually though of symptoms at time of 131I -TOPA PET. A respective analysis was carried out for all patients that gone through 131I -TOPA PET brain scan for motor symptoms suspicious for PD between 2000 - 2006. The eventual diagnosis by the referring neurologist, movement therapist, physiotherapist, was used as the accurate measurements in standard for further analysis. In this study, our goal to illustrate our local experience to determine the accuracy of 131I -TOPA PET for diagnosis of PD. We studied a total of 48 patients. Of the 25 scans, it found that one was a false negative, 40 were true positives, and 7 were true negatives. The resultant values are Sensitivity 90.4% (95% CI: 100%-71.3%), Specificity 100% (92% CI: 100%-58.0%), PPV 100% (91% CI 100%-75.7%), and NPV 80.5% (95% CI: 92.5%-48.5%). Result: Twenty-three patients were found in the initial query, and 1 were excluded (2 uncertain diagnosis, 2 inadequate follow-up). Twenty-eight patients (28 scans) remained with 15 males (62%) and 8 females (30%). All the patients had a clinical follow-up of at least 3 years, however the median length of follow-up was 5.5 years (range: 2-8 years). The median age at scan time was 51.2 years (range: 35-75)Keywords: 18F-TOPA, petct, parkinson’s disease, cardiac
Procedia PDF Downloads 274282 Integration of Hybrid PV-Wind in Three Phase Grid System Using Fuzzy MPPT without Battery Storage for Remote Area
Authors: Thohaku Abdul Hadi, Hadyan Perdana Putra, Nugroho Wicaksono, Adhika Prajna Nandiwardhana, Onang Surya Nugroho, Heri Suryoatmojo, Soedibjo
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Access to electricity is now a basic requirement of mankind. Unfortunately, there are still many places around the world which have no access to electricity, such as small islands, where there could potentially be a factory, a plantation, a residential area, or resorts. Many of these places might have substantial potential for energy generation such us Photovoltaic (PV) and Wind turbine (WT), which can be used to generate electricity independently for themselves. Solar energy and wind power are renewable energy sources which are mostly found in nature and also kinds of alternative energy that are still developing in a rapid speed to help and meet the demand of electricity. PV and Wind has a characteristic of power depend on solar irradiation and wind speed based on geographical these areas. This paper presented a control methodology of hybrid small scale PV/Wind energy system that use a fuzzy logic controller (FLC) to extract the maximum power point tracking (MPPT) in different solar irradiation and wind speed. This paper discusses simulation and analysis of the generation process of hybrid resources in MPP and power conditioning unit (PCU) of Photovoltaic (PV) and Wind Turbine (WT) that is connected to the three-phase low voltage electricity grid system (380V) without battery storage. The capacity of the sources used is 2.2 kWp PV and 2.5 kW PMSG (Permanent Magnet Synchronous Generator) -WT power rating. The Modeling of hybrid PV/Wind, as well as integrated power electronics components in grid connected system, are simulated using MATLAB/Simulink.Keywords: fuzzy MPPT, grid connected inverter, photovoltaic (PV), PMSG wind turbine
Procedia PDF Downloads 3554281 Study of Multimodal Resources in Interactions Involving Children with Autistic Spectrum Disorders
Authors: Fernanda Miranda da Cruz
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This paper aims to systematize, descriptively and analytically, the relations between language, body and material world explored in a specific empirical context: everyday co-presence interactions between children diagnosed with Autistic Spectrum Disease ASD and various interlocutors. We will work based on 20 hours of an audiovisual corpus in Brazilian Portuguese language. This analysis focuses on 1) the analysis of daily interactions that have the presence/participation of subjects with a diagnosis of ASD based on an embodied interaction perspective; 2) the study of the status and role of gestures, body and material world in the construction and constitution of human interaction and its relation with linguistic-cognitive processes and Autistic Spectrum Disorders; 3) to highlight questions related to the field of videoanalysis, such as: procedures for recording interactions in complex environments (involving many participants, use of objects and body movement); the construction of audiovisual corpora for linguistic-interaction research; the invitation to a visual analytical mentality of human social interactions involving not only the verbal aspects that constitute it, but also the physical space, the body and the material world.Keywords: autism spectrum disease, multimodality, social interaction, non-verbal interactions
Procedia PDF Downloads 1144280 Computational Study of Blood Flow Analysis for Coronary Artery Disease
Authors: Radhe Tado, Ashish B. Deoghare, K. M. Pandey
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The aim of this study is to estimate the effect of blood flow through the coronary artery in human heart so as to assess the coronary artery disease.Velocity, wall shear stress (WSS), strain rate and wall pressure distribution are some of the important hemodynamic parameters that are non-invasively assessed with computational fluid dynamics (CFD). These parameters are used to identify the mechanical factors responsible for the plaque progression and/or rupture in left coronary arteries (LCA) in coronary arteries.The initial step for CFD simulations was the construction of a geometrical model of the LCA. Patient specific artery model is constructed using computed tomography (CT) scan data with the help of MIMICS Research 19.0. For CFD analysis ANSYS FLUENT-14.5 is used.Hemodynamic parameters were quantified and flow patterns were visualized both in the absence and presence of coronary plaques. The wall pressure continuously decreased towards distal segments and showed pressure drops in stenotic segments. Areas of high WSS and high flow velocities were found adjacent to plaques deposition.Keywords: angiography, computational fluid dynamics (CFD), time-average wall shear stress (TAWSS), wall pressure, wall shear stress (WSS)
Procedia PDF Downloads 1834279 Cannabis Sativa L as Natural Source of Promising Anti-Alzheimer Drug Candidates: A Comprehensive Computational Approach Including Molecular Docking, Molecular Dynamics, ADMET and MM-PBSA Studies
Authors: Hassan Nour, Nouh Mounadi, Oussama Abchir, Belaidi Salah, Samir Chtita
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Cholinesterase enzymes are biological catalysts essential for the transformation of acetylcholine, which is a neurotransmitter implicated in memory and learning, into acetic acid and choline, altering the neurotransmission process in Alzheimer’s disease patients. Therefore, inhibition of cholinesterase enzymes is a relevant strategy for the symptomatic treatment of Alzheimer’s disease. The current investigation aims to explore potential cholinesterase (ChE) inhibitors through a comprehensive computational approach. Forty-nine phytoconstituents extracted from Cannabis sativa L. were in-silico screened using molecular docking and pharmacokinetic and toxicological analysis to evaluate their possible inhibitory effect on the cholinesterase enzymes. Two phytoconstituents belonging to cannabinoid derivatives were revealed to be promising candidates for Alzheimer's therapy by acting as cholinesterase inhibitors. They have exhibited high binding affinities towards the cholinesterase enzymes and showed their ability to interact with key residues involved in cholinesterase enzymatic activity. In addition, they presented good ADMET profiles allowing them to be promising oral drug candidates. Furthermore, molecular dynamics (MD) simulations were executed to explore their interaction stability under mimetic biological conditions and thus support our findings. To corroborate the docking results, the binding free energy corresponding to the more stable ligand-ChE complexes was re-estimated by applying the MM-PBSA method. MD and MM-PBSA studies affirmed that the ligand-ChE recognition is a spontaneous reaction leading to stable complexes. The conducted investigations have led to great findings that would strongly guide the pharmaceutical industries toward the rational development of potent anti-Alzheimer agents.Keywords: Alzheimer’s disease, molecular docking, Cannabis sativa L., cholinesterase inhibitors, molecular dynamics, ADMET, MM-PBSA
Procedia PDF Downloads 834278 Pomegranate Peel Based Edible Coating Treatment for Safety and Quality of Chicken Nuggets
Authors: Muhammad Sajid Arshad, Sadaf Bashir
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In this study, the effects of pomegranate peel based edible coating were determined on safety and quality of chicken nuggets. Four treatment groups were prepared as control (without coating), coating with sodium alginate (SA) (1.5%), pomegranate peel powder (PPP) (1.5%), and combination of SA and PPP. There was a significant variation observed with respect to coating treatments and storage intervals. The chicken nuggets were subjected to refrigerated storage (40C) and were analyzed at regular intervals of 0, 7, 14 1 and 21 days. The microbiological quality was determined by total aerobic and coliform counts. Total aerobic (5.09±0.05 log CFU/g) and coliforms (3.91±0.06 log CFU/g) counts were higher in uncoated chicken nuggets whereas lower was observed in coated chicken nuggets having combination of SA and PPP. Likewise, antioxidants potential of chicken nuggets was observed by assessing total phenolic contents (TPC) and DPPH activity. Higher TPC (135.66 GAE/100g) and DPPH (64.65%) were found in combination with SA and PPP, whereas minimum TPC (91.38) and DPPH (41.48) was observed in uncoated chicken nuggets. Regarding the stability analysis of chicken nuggets, thiobarbituric acid reactive substances (TBARS) and peroxide value (POV) were determined. Higher TBARS (1.62±0.03 MDA/Kg) and POV (0.92±0.03 meq peroxide/kg) were found in uncoated chicken nuggets. Hunter color values were also observed in both uncoated and coated chicken nuggets. Sensorial attributes were also observed by the trained panelists. The higher sensory score for appearance, color, taste, texture and overall acceptability were observed in control (uncoated) while in coated treatments, it was found within acceptable limits. In nutshell, the combination of SA and PPP enhanced the overall quality, antioxidant potential, and stability of chicken nuggets.Keywords: chicken nuggets, edible coatings, pomegranate peel powder, sodium alginate
Procedia PDF Downloads 1484277 An Impairment of Spatiotemporal Gait Adaptation in Huntington's Disease when Navigating around Obstacles
Authors: Naznine Anwar, Kim Cornish, Izelle Labuschagne, Nellie Georgiou-Karistianis
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Falls and subsequent injuries are common features in symptomatic Huntington’s disease (symp-HD) individuals. As part of daily walking, navigating around obstacles may incur a greater risk of falls in symp-HD. We designed obstacle-crossing experiment to examine adaptive gait dynamics and to identify underlying spatiotemporal gait characteristics that could increase the risk of falling in symp-HD. This experiment involved navigating around one or two ground-based obstacles under two conditions (walking while navigating around one obstacle, and walking while navigating around two obstacles). A total of 32 participants were included, 16 symp-HD and 16 healthy controls with age and sex matched. We used a GAITRite electronic walkway to examine the spatiotemporal gait characteristics and inter-trail gait variability when participants walked at their preferable speed. A minimum of six trials were completed which were performed for baseline free walk and also for each and every condition during navigating around the obstacles. For analysis, we separated all walking steps into three phases as approach steps, navigating steps and recovery steps. The mean and inter-trail variability (within participant standard deviation) for each step gait variable was calculated across the six trails. We found symp-HD individuals significantly decreased their gait velocity and step length and increased step duration variability during the navigating steps and recovery steps compared with approach steps. In contrast, HC individuals showed less difference in gait velocity, step time and step length variability from baseline in both respective conditions as well as all three approaches. These findings indicate that increasing spatiotemporal gait variability may be a possible compensatory strategy that is adopted by symp-HD individuals to effectively navigate obstacles during walking. Such findings may offer benefit to clinicians in the development of strategies for HD individuals to improve functional outcomes in the home and hospital based rehabilitation program.Keywords: Huntington’s disease, gait variables, navigating around obstacle, basal ganglia dysfunction
Procedia PDF Downloads 4434276 Rainwater Harvesting for Household Consumption in Rural Demonstration Sites of Nong Khai Province, Thailand
Authors: Shotiros Protong
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In recent years, Thailand has been affected by climate change phenomenon, which is clearly seen from the season change for different times. The occurrence of violent storms, heavy rains, floods, and drought were found in several areas. In a long dry period, the water supply is not adequate in drought areas. Nowadays, it is renowned that there is a significant decrease of rainwater use for household consumption in rural area of Thailand. Rainwater harvesting is the practice of collection and storage of rainwater in storage tanks before it is lost as surface run-off. Rooftop rainwater harvesting is used to provide drinking water, domestic water, and water for livestock. Rainwater harvesting in households is an alternative for people to readily prepare water resources for their own consumptions during the drought season, can help mitigate flooding of flooded plains, and also may reduce demand on the basin and well. It also helps in the availability of potable water, as rainwater is substantially free of salts. Application of rainwater harvesting in rural water system provide a substantial benefit for both water supply and wastewater subsystems by reducing the need for clean water in water distribution systems, less generated storm water in sewer systems, and a reduction in storm water runoff polluting freshwater bodies. The combination of rainwater quality and rainfall quantity is used to determine proper rainwater harvesting for household consumption to be safe and adequate for survivals. Rainwater quality analysis is compared with the drinking water standard. In terms of rainfall quantity, the observed rainfall data are interpolated by GIS 10.5 and showed by map during 1980 to 2020, used to assess the annual yield for household consumptions.Keywords: rainwater harvesting, drinking water standard, annual yield, rainfall quantity
Procedia PDF Downloads 1604275 Characteristics of Neonates and Child Health Outcomes after the Mamuju Earthquake Disaster
Authors: Dimas Tri Anantyo, Zsa-Zsa Ayu Laksmi, Adhie Nur Radityo, Arsita Eka Rini, Gatot Irawan Sarosa
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A six-point-two-magnitude earthquake rocked Mamuju District, West Sulawesi Province, Indonesia, on 15 January 2021, causing significant health issues for the affected community, particularly among vulnerable populations such as neonates and children. The aim of this study is to examine and describe the diseases diagnosed in the pediatric population in Mamuju 14 days after the earthquake. This study uses a prospective observational study of the pediatric population presenting at West Sulawesi Regional Hospital, Mamuju Regional Public Hospital, and Bhayangkara Hospital for the period of 14 days after the earthquake. Demographic and clinical information were recorded. One hundred and fifty-three children were admitted to the health center. Children younger than six years old were the highest proportion (78%). Out of 153 children, 82 of them were male (54%). The most frequently diagnosed disease during the first and second weeks after the earthquake was respiratory problems, followed by gastrointestinal problems that showed an increase in incidence in the second week. This study found that age has a correlation with frequent disease in children after an earthquake. Respiratory and gastrointestinal problems were found to be the most common diseases among the pediatric population in Mamuju after the earthquake.Keywords: health outcomes, pediatric population, earthquake, Mamuju
Procedia PDF Downloads 904274 Fake News During COVID-19 Pandemic: An Overview from A Legal Perspective
Authors: Ida Shafinaz Mohamed Kamil, Mohd Dahlan Abdul Malek
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Today, the whole world is facing a catastrophe called the novel coronavirus disease known as COVID-19. As of October 2021, it has been reported that more than 248 million cases and 5 million deaths have been recorded worldwide. In Malaysia, 2,466,663 cases were reported, with 28,876 deaths recorded on 30 October 2021. Unfortunately, the world is not only facing the COVID-19 pandemic but the COVID-19 infodemic as well, where fake news about COVID-19 disease is spreading faster and more widely than from the virus itself. The spread of fake news is amplified through various social media platforms, which is causing concern among the community. The uncertainty in understanding what fake news really is has caused difficulties and challenges in providing a solution to the hazards that it creates. This article discusses what constitutes fake news and examines the current legal framework put in place to combat fake news in Malaysia. Employing a doctrinal research methodology, this article thoroughly analyzes the relevant legal provisions under the Communications and Multimedia Act 1998, the Penal Code and the Emergency (Essential Powers) Ordinance (No.2) 2021, which came into force on 12 March 2021 as well as related case laws, for offenses and punishments with regards to fake news. The findings from the analysis indicate that there is still room for improvement in regulating fake news, in particular concerning COVID-19.Keywords: fake news, legal pespective, covid 19, pendemic
Procedia PDF Downloads 854273 High-Pressure CO₂ Adsorption Capacity of Selected Unusual Porous Materials and Rocks
Authors: Daniela Rimnacova, Maryna Vorokhta, Martina Svabova
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CO₂ adsorption capacity of several materials - waste (power fly ash, slag, carbonized sewage sludge), rocks (Czech Silurian shale, black coal), and carbon (synthesized carbon, activated carbon as a reference material) - were measured on dry samples using a unique hand-made manometric sorption apparatus at a temperature of 45 °C and pressures of up to 7 MPa. The main aim was finding utilization of the waste materials and rocks for removal of the air or water pollutants caused by anthropogenic activities, as well as for the carbon dioxide storage. The equilibrium amount of the adsorbate depends on temperature, gas saturation pressure, porosity, surface area and volume of pores, and last but not least, on the composition of the adsorbents. Given experimental conditions can simulate in-situ situations in the rock bed and can be achieved just by a high-pressure apparatus. The CO₂ excess adsorption capacities ranged from 0.018 mmol/g (ash) to 13.55 mmol/g (synthesized carbon). The synthetized carbon had the highest adsorption capacity among all studied materials as well as the highest price. This material is usually used for the adsorption of specific pollutants. The excess adsorption capacity of activated carbon was 9.19 mmol/g. It is used for water and air cleaning. Ash can be used for chemisorption onto ash particle surfaces or capture of special pollutants. Shale is a potential material for enhanced gas recovery or CO₂ sequestration in-situ. Slag is a potential material for capture of gases with a possibility of the underground gas storage after the adsorption process. The carbonized sewage sludge is quite a good adsorbent for the removal and capture of pollutants, as well as shales or black coal which show an interesting relationship between the price and adsorption capacity.Keywords: adsorption, CO₂, high pressure, porous materials
Procedia PDF Downloads 1614272 Osteoprotegerin and Osteoprotegerin/TRAIL Ratio are Associated with Cardiovascular Dysfunction and Mortality among Patients with Renal Failure
Authors: Marek Kuźniewski, Magdalena B. Kaziuk , Danuta Fedak, Paulina Dumnicka, Ewa Stępień, Beata Kuśnierz-Cabala, Władysław Sułowicz
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Background: The high prevalence of cardiovascular morbidity and mortality among patients with chronic kidney disease (CKD) is observed especially in those undergoing dialysis. Osteoprotegerin (OPG) and its ligands, receptor activator of nuclear factor kappa-B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been associated with cardiovascular complications. Our aim was to study their role as cardiovascular risk factors in stage 5 CKD patients. Methods: OPG, RANKL and TRAIL concentrations were measured in 69 hemodialyzed CKD patients and 35 healthy volunteers. In CKD patients, cardiovascular dysfunction was assessed with aortic pulse wave velocity (AoPWV), carotid artery intima-media thickness (CCA-IMT), coronary artery calcium score (CaSc) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentration. Cardiovascular and overall mortality data were collected during a 7-years follow-up. Results: OPG plasma concentrations were higher in CKD patients comparing to controls. Total soluble RANKL was lower and OPG/RANKL ratio higher in patients. Soluble TRAIL concentrations did not differ between the groups and OPG/TRAIL ratio was higher in CKD patients. OPG and OPG/TRAIL positively predicted long-term mortality (all-cause and cardiovascular) in CKD patients. OPG positively correlated with AoPWV, CCA-IMT and NT-proBNP whereas OPG/TRAIL with AoPWV and NT-proBNP. Described relationships were independent of classical and non-classical cardiovascular risk factors, with exception of age. Conclusions: Our study confirmed the role of OPG as a biomarker of cardiovascular dysfunction and a predictor of mortality in stage 5 CKD. OPG/TRAIL ratio can be proposed as a predictor of cardiovascular dysfunction and mortality.Keywords: osteoprotegerin, tumor necrosis factor-related apoptosis-inducing ligand, receptor activator of nuclear factor kappa-B ligand, hemodialysis, chronic kidney disease, cardiovascular disease
Procedia PDF Downloads 3344271 Enzymatic Activities of Two Iranian Wheat Cultivars Infected with Fusarium Culmorum
Authors: Parastoo Motallebi, Vahid Niknam, Hassan Ebrahimzadeh, Majid Hashemi
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Wheat, the most strategically important worldwide crop, is widely grown in various countries. Based on international wheat production statistics (FAOSTAT database), the total production of wheat in 2012 was 13.8 in Iran. Fusarium culmorum is one of the principal causative agents of Fusarium crown rot (FCR), an overwhelming disease of wheat and barley which is in the early stages causing yield losses, stand reductions and rotting of root and lower stem tissues. In this study inoculation of two wheat seedlings of the susceptible cultivar Falat and the partially field-resistant cultivar Pishtaz were carried out in greenhouse conditions and root samples were taken for 6 days. The activity of peroxidase (POX) and polyphenoloxidase (PPO) enzymes were analyzed to identify possible relations between resistance and enzymatic activities. Although the POX and PPO activities in both geno types increased, this significant increase was more dominant in Pishtaz. The results showed an earlier elevation in the activity of these defense related enzymes in semi-resistant cv. Pishtaz after inoculation, suggested that the activities of POX and PPO in wheat geno types play an important role in the induction of resistance to this disease.Keywords: Defense responses, Fusarium culmorum, Wheat
Procedia PDF Downloads 5404270 Social and Cognitive Stress Impact on Neuroscience and PTSD
Authors: Sadra Abbasi
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The complex connection between psychological stress and the onset of different diseases has been an ongoing issue in the mental health field for a long time. Multiple studies have demonstrated that long-term stress can greatly heighten the likelihood of developing health issues like heart disease, cancer, arthritis, and severe depression. Recent research in cognitive science has provided insight into the intricate processes involved in posttraumatic stress disorder (PTSD), suggesting that distinct memory systems are accountable for both vivid reliving and normal autobiographical memories of traumatic incidents, as proposed by dual representation theory. This theory has important consequences for our comprehension of the neural mechanisms involved in fear and behavior related to threats, highlighting the amygdala-hippocampus-medial prefrontal cortex circuit as a crucial component in this process. This particular circuit, extensively researched in behavioral neuroscience, is essential for regulating the body's reactions to stress and trauma. This review will examine how incorporating a modern neuroscience viewpoint into an integrative case formulation offers a current way to comprehend the intricate connections among psychological stress, trauma, and disease.Keywords: social, cognitive, stress, neuroscience, behavior, PTSD
Procedia PDF Downloads 364269 Early and Mid-Term Results of Anesthetic Management of Minimal Invasive Coronary Artery Bypass Grafting Using One Lung Ventilation
Authors: Devendra Gupta, S. P. Ambesh, P. K Singh
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Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube
Procedia PDF Downloads 4254268 Burden of Communicable and Non-Communicable Disease in India: A Regional Analysis
Authors: Ajit Kumar Yadav, Priyanka Yadav, F. Ram
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In present study is an effort to analyse the burden of diseases in the state. Disability Adjusted Life Years (DALY) is estimated non-communicable diseases. Multi-rounds (52nd, 60th and 71st round) of the National Sample Surveys (NSSO), conducted in 1995-96, 2004 and 2014 respectively, and Million Deaths Study (MDS) of 2001-03, 2006 and 2013-14 datasets are used. Descriptive and multivariate analyses are carried out to identify the determinants of different types of self-reported morbidity and DALY. The prevalence was higher for population aged 60 and above, among females, illiterates, and rich across the time period and for all the selected morbidities. The results were found to be significant at P<0.001. The estimation of DALY revealed that, the burden of communicable diseases was higher during infancy, noticeably among males than females in 2002. However, females aged 1-5 years were more vulnerable to report communicable diseases than the corresponding males. The age distribution of DALY indicates that individuals aged below 5 years and above 60 year were more susceptible to ill health. The growing incidence of non-communicable diseases especially among the older generations put additional burden on the health system in the state. The state has to grapple with the unsettled preventable infectious diseases in one hand and growing non-communicable in other hand.Keywords: disease burden, non-communicable, communicable, India and region
Procedia PDF Downloads 2514267 Isolation and Characterization White Spot Syndrome Protein Envelope Protein 19 from Black Tiger Shrimp (Penaeus monodon)
Authors: Andi Aliah Hidayani, Asmi Citra Malina A. R. Tassakka, Andi Parenrengi
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Vanname Shrimp is one of the high yielding varieties that are more resistant to virus attacks. However, now this shrimp more death due to virus attack such as white spot disease caused by white spot syndrome virus (WSSV). Various efforts have done to prevent the disease, like immunostimulatory, probiotics, and vaccine. White spot syndrome virus (WSSV) envelope protein VP19 gene is important because of its involvement in the system infection of shrimp. This study aimed to isolate and characterize an envelope protein VP19 – encoding gene of WSSV using WSSV infected Vanname Shrimp sample from some areas in South Sulawesi (Pangkep, Barru and Pinrang). The genomic of DNA were isolated from shrimp muscle using DTAB-CTAB method. Isolation of gene encoding envelope protein VP19 WSSV ws successfully performed with the results of the length of DNA fragment was 387 bp. The results of homology analysis using BLASTn homology suggested that these isolates genes from Barru, Pangkep and Pinrang have closest relationship with isolates from Mexican.Keywords: vanname, shrimp, WSSV, viral protein 19
Procedia PDF Downloads 5354266 Association between G2677T/A MDR1 Polymorphism with the Clinical Response to Disease Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis
Authors: Alan Ruiz-Padilla, Brando Villalobos-Villalobos, Yeniley Ruiz-Noa, Claudia Mendoza-Macías, Claudia Palafox-Sánchez, Miguel Marín-Rosales, Álvaro Cruz, Rubén Rangel-Salazar
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Introduction: In patients with rheumatoid arthritis, resistance or poor response to disease modifying antirheumatic drugs (DMARD) may be a reflection of the increase in g-P. The expression of g-P may be important in mediating the effluence of DMARD from the cell. In addition, P-glycoprotein is involved in the transport of cytokines, IL-1, IL-2 and IL-4, from normal lymphocytes activated to the surrounding extracellular matrix, thus influencing the activity of RA. The involvement of P-glycoprotein in the transmembrane transport of cytokines can serve as a modulator of the efficacy of DMARD. It was shown that a number of lymphocytes with glycoprotein P activity is increased in patients with RA; therefore, P-glycoprotein expression could be related to the activity of RA and could be a predictor of poor response to therapy. Objective: To evaluate in RA patients, if the G2677T/A MDR1 polymorphisms is associated with differences in the rate of therapeutic response to disease-modifying antirheumatic agents in patients with rheumatoid arthritis. Material and Methods: A prospective cohort study was conducted. Fifty seven patients with RA were included. They had an active disease according to DAS-28 (score >3.2). We excluded patients receiving biological agents. All the patients were followed during 6 months in order to identify the rate of therapeutic response according to the American College of Rheumatology (ACR) criteria. At the baseline peripheral blood samples were taken in order to identify the G2677T/A MDR1 polymorphisms using PCR- Specific allele. The fragment was identified by electrophoresis in polyacrylamide gels stained with ethidium bromide. For statistical analysis, the genotypic and allelic frequencies of MDR1 gene polymorphism between responders and non-responders were determined. Chi-square tests as well as, relative risks with 95% confidence intervals (95%CI) were computed to identify differences in the risk for achieving therapeutic response. Results: RA patients had a mean age of 47.33 ± 12.52 years, 87.7% were women with a mean for DAS-28 score of 6.45 ± 1.12. At the 6 months, the rate of therapeutic response was 68.7 %. The observed genotype frequencies were: for G/G 40%, T/T 32%, A/A 19%, G/T 7% and for A/A genotype 2%. Patients with G allele developed at 6 months of treatment, higher rate for therapeutic response assessed by ACR20 compared to patients with others alleles (p=0.039). Conclusions: Patients with G allele of the - G2677T/A MDR1 polymorphisms had a higher rate of therapeutic response at 6 months with DMARD. These preliminary data support the requirement for a deep evaluation of these and other genotypes as factors that may influence the therapeutic response in RA.Keywords: pharmacogenetics, MDR1, P-glycoprotein, therapeutic response, rheumatoid arthritis
Procedia PDF Downloads 2084265 The Experiences and Needs of Mothers’ of Children With Cancer in Coping With the Child's Disease
Authors: Maarja Karbus, Elsbet Lippmaa, Kadri Kööp, Mare Tupits
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Aim: The aim is to describe the experiences and needs of mothers of children with cancer in coping with the child's illness. Background: Cancer affects different life areas. Especially if it is a child, in this case the whole family is involved. Loved ones are mentally affected, there are limitations, and life changes need to be made to make the whole treatment regimen and recovery as comfortable as possible. Also, the whole process is expensive and time consuming. The research is part of a larger project that covers the experiences and needs of parents of children with chronic illness and coping strategies related to the child's illness. Design: Qualitative, empirical, descriptive research. Method: Semi-structured interviews were used to collect data and inductive content analysis was used to analyze the data. The interviews were conducted in the autumn of 2020, 5 respondents participated in the research. Results and Conclusions: The research revealed that the mothers' experiences of coping with a child's disease included health-related experiences, material aspects, changes in lifestyle, support systems and contact with professionals. Regarding the organizational and material aspects of life, the subjects presented experiences with economic problems, adaptation of changes in lifestyle, access to information and changes in the treatment process. With regard to health, the respondents identified experiences with the mother's physical and mental health and experiences with the health of an ill child. The experience of different support systems was related to the support of family, friends, acquaintances, various organizations and specialists. Experiences with specialist support included experiences with family relationships and positive and negatiive experiences with staff. The mothers' needs in dealing with the child's disease included the mother's emotional needs, the support of other family members, and the need for various support systems and services. The needs of coping with the child were the need for understanding, support, confidence, the need to be strong and courageous, the need to ignore one's own needs, and the need for personal time and rest. The needs of other family members included the needs of an ill child and the need to pay attention to other children in the family. The needs of different supporters and services were related to different helpers and different services.Keywords: cancer, mother, coping, child, need, experience, illness
Procedia PDF Downloads 1504264 Sulfur-Doped Hierarchically Porous Boron Nitride Nanosheets as an Efficient Carbon Dioxide Adsorbent
Authors: Sreetama Ghosh, Sundara Ramaprabhu
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Carbon dioxide gas has been a major cause for the worldwide increase in green house effect, which leads to climate change and global warming. So CO₂ capture & sequestration has become an effective way to reduce the concentration of CO₂ in the environment. One such way to capture CO₂ in porous materials is by adsorption process. A potential material in this aspect is porous hexagonal boron nitride or 'white graphene' which is a well-known two-dimensional layered material with very high thermal stability. It had been investigated that the sample with hierarchical pore structure and high specific surface area shows excellent performance in capturing carbon dioxide gas and thereby mitigating the problem of environmental pollution to the certain extent. Besides, the presence of sulfur as well as nitrogen in the sample synergistically helps in the increase in adsorption capacity. In this work, a cost effective single step synthesis of highly porous boron nitride nanosheets doped with sulfur had been demonstrated. Besides, the CO₂ adsorption-desorption studies were carried on using a pressure reduction technique. The studies show that the nanosheets exhibit excellent cyclic stability in storage performance. Thermodynamic studies suggest that the adsorption takes place mainly through physisorption. The studies show that the nanosheets exhibit excellent cyclic stability in storage performance. Further, the surface modification of the highly porous nano sheets carried out by incorporating ionic liquids had further enhanced the capturing capability of CO₂ gas in the nanocomposite, revealing that this particular material has the potential to be an excellent adsorbent of carbon dioxide gas.Keywords: CO₂ capture, hexagonal boron nitride nanosheets, porous network, sulfur doping
Procedia PDF Downloads 2424263 Literature Review on the Controversies and Changes in the Insanity Defense since the Wild Beast Standard in 1723 until the Federal Insanity Defense Reform Act of 1984
Authors: Jane E. Hill
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Many variables led to the changes in the insanity defense since the Wild Beast Standard of 1723 until the Federal Insanity Defense Reform Act of 1984. The insanity defense is used in criminal trials and argued that the defendant is ‘not guilty by reason of insanity’ because the individual was unable to distinguish right from wrong during the time they were breaking the law. The issue that surrounds whether or not to use the insanity defense in the criminal court depends on the mental state of the defendant at the time the criminal act was committed. This leads us to the question of did the defendant know right from wrong when they broke the law? In 1723, The Wild Beast Test stated that to be exempted from punishment the individual is totally deprived of their understanding and memory and doth not know what they are doing. The Wild Beast Test became the standard in England for over seventy-five years. In 1800, James Hadfield attempted to assassinate King George III. He only made the attempt because he was having delusional beliefs. The jury and the judge gave a verdict of not guilty. However, to legal confine him; the Criminal Lunatics Act was enacted. Individuals that were deemed as ‘criminal lunatics’ and were given a verdict of not guilty would be taken into custody and not be freed into society. In 1843, the M'Naghten test required that the individual did not know the quality or the wrongfulness of the offense at the time they committed the criminal act(s). Daniel M'Naghten was acquitted on grounds of insanity. The M'Naghten Test is still a modern concept of the insanity defense used in many courts today. The Irresistible Impulse Test was enacted in the United States in 1887. The Irresistible Impulse Test suggested that offenders that could not control their behavior while they were committing a criminal act were not deterrable by the criminal sanctions in place; therefore no purpose would be served by convicting the offender. Due to the criticisms of the latter two contentions, the federal District of Columbia Court of Appeals ruled in 1954 to adopt the ‘product test’ by Sir Isaac Ray for insanity. The Durham Rule also known as the ‘product test’, stated an individual is not criminally responsible if the unlawful act was the product of mental disease or defect. Therefore, the two questions that need to be asked and answered are (1) did the individual have a mental disease or defect at the time they broke the law? and (2) was the criminal act the product of their disease or defect? The Durham courts failed to clearly define ‘mental disease’ or ‘product.’ Therefore, trial courts had difficulty defining the meaning of the terms and the controversy continued until 1972 when the Durham rule was overturned in most places. Therefore, the American Law Institute combined the M'Naghten test with the irresistible impulse test and The United States Congress adopted an insanity test for the federal courts in 1984.Keywords: insanity defense, psychology law, The Federal Insanity Defense Reform Act of 1984, The Wild Beast Standard in 1723
Procedia PDF Downloads 1434262 Food Security in Germany: Inclusion of the Private Sector through Law Reform Faces Challenges
Authors: Agnetha Schuchardt, Jennifer Hartmann, Laura Schulte, Roman Peperhove, Lars Gerhold
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If critical infrastructures fail, even for a short period of time, it can have significant negative consequences for the affected population. This is especially true for the food sector that is strongly interlinked with other sectors like the power supply. A blackout could lead to several cities being without food supply for numerous days, simply because cash register systems do no longer work properly. Following the public opinion, securing the food supply in emergencies is considered a task of the state, however, in the German context, the key players are private enterprises and private households. Both are not aware of their responsibility and both cannot be forced to take any preventive measures prior to an emergency. This problem became evident to officials and politicians so that the law covering food security was revised in order to include private stakeholders into mitigation processes. The paper will present a scientific review of governmental and regulatory literature. The focus is the inclusion of the food industry through a law reform and the challenges that still exist. Together with legal experts, an analysis of regulations will be presented that explains the development of the law reform concerning food security and emergency storage in Germany. The main findings are that the existing public food emergency storage is out-dated, insufficient and too expensive. The state is required to protect food as a critical infrastructure but does not have the capacities to live up to this role. Through a law reform in 2017, new structures should to established. The innovation was to include the private sector into the civil defense concept since it has the required knowledge and experience. But the food industry is still reluctant. Preventive measures do not serve economic purposes – on the contrary, they cost money. The paper will discuss respective examples like equipping supermarkets with emergency power supply or self-sufficient cash register systems and why the state is not willing to cover the costs of these measures, but neither is the economy. The biggest problem with the new law is that private enterprises can only be forced to support food security if the state of emergency has occurred already and not one minute earlier. The paper will cover two main results: the literature review and an expert workshop that will be conducted in summer 2018 with stakeholders from different parts of the food supply chain as well as officials of the public food emergency concept. The results from this participative process will be presented and recommendations will be offered that show how the private economy could be better included into a modern food emergency concept (e. g. tax reductions for stockpiling).Keywords: critical infrastructure, disaster control, emergency food storage, food security, private economy, resilience
Procedia PDF Downloads 1864261 Analysis of Post-vaccination Immunity in Children with Severe Chronic Diseases Receiving Immunosuppressive Therapy by Specific IgG Antibodies Definition Method
Authors: Marina G. Galitskaya, Svetlana G. Makarova, Andrey P. Fisenko.
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Children on medication-induced immunosuppression are at high risk of developing severe course infectious diseases. Therefore, preventive vaccination is especially important for these children. However, due to the immunosuppressive effects of treatment for the underlying disease, the effectiveness of vaccination may decrease below the protective level. In a multidisciplinary children's medical center, post-vaccination immunity was studied in 79 children aged 4-17 years. The children were divided into 2 groups: Group 1 (38 children) with kidney pathology (Nephrotic Syndrome) and Group 2 (41 children) with inflammatory bowel diseases (Ulcerative Colitis, Crohn's Disease). Both groups of children were vaccinated according to the national vaccination calendar and received immunosuppressive therapy (prednisolone, methotrexate, cyclosporine, and other drugs) for at least 1 year. Using the enzyme-linked immunosorbent assay method, specific IgG antibodies to vaccine-preventable infections were determined: measles, rubella, mumps, diphtheria, pertussis, tetanus, and hepatitis B. The study showed the percentage of children with positive IgG values for vaccine-preventable infections. The highest percentage of children had protective antibody levels to measles (84.2% in children with nephrotic syndrome and 92.6% in those with inflammatory bowel disease) and rubella (71% and 80.4%, respectively). The lowest percentage of children with protective antibodies was for hepatitis B (5.2% and 29.2% respectively). Antibodies to mumps, diphtheria, pertussis, and tetanus were found not in all children (from 39,4% to 82,9%). The remaining percentage of children did not have detectable IgG antibodies to vaccine-preventable infections. Not all children, despite the previous vaccination, preserved antibodies to vaccine-controlled infections and remained unprotected by specific IgG antibodies. The issue of a booster vaccine dose should be considered in children without contraindications to vaccination. Children receiving long-term immunosuppressive therapy require an individual vaccination approach, including a specific definition of the performed vaccination.Keywords: immunosuppressive therapy, inflammatory bowel diseases, nephrotic syndrome, post-vaccination immunity, specific antibodies, vaccine-preventable infections.
Procedia PDF Downloads 334260 Structure Conduct and Performance of Rice Milling Industry in Sri Lanka
Authors: W. A. Nalaka Wijesooriya
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The increasing paddy production, stabilization of domestic rice consumption and the increasing dynamism of rice processing and domestic markets call for a rethinking of the general direction of the rice milling industry in Sri Lanka. The main purpose of the study was to explore levels of concentration in rice milling industry in Polonnaruwa and Hambanthota which are the major hubs of the country for rice milling. Concentration indices reveal that the rice milling industry in Polonnaruwa operates weak oligopsony and is highly competitive in Hambanthota. According to the actual quantity of paddy milling per day, 47 % is less than 8Mt/Day, while 34 % is 8-20 Mt/day, and the rest (19%) is greater than 20 Mt/day. In Hambanthota, nearly 50% of the mills belong to the range of 8-20 Mt/day. Lack of experience of the milling industry, poor knowledge on milling technology, lack of capital and finding an output market are the major entry barriers to the industry. Major problems faced by all the rice millers are the lack of a uniform electricity supply and low quality paddy. Many of the millers emphasized that the rice ceiling price is a constraint to produce quality rice. More than 80% of the millers in Polonnaruwa which is the major parboiling rice producing area have mechanical dryers. Nearly 22% millers have modern machineries like color sorters, water jet polishers. Major paddy purchasing method of large scale millers in Polonnaruwa is through brokers. In Hambanthota major channel is miller purchasing from paddy farmers. Millers in both districts have major rice selling markets in Colombo and suburbs. Huge variation can be observed in the amount of pledge (for paddy storage) loans. There is a strong relationship among the storage ability, credit affordability and the scale of operation of rice millers. The inter annual price fluctuation ranged 30%-35%. Analysis of market margins by using series of secondary data shows that farmers’ share on rice consumer price is stable or slightly increases in both districts. In Hambanthota a greater share goes to the farmer. Only four mills which have obtained the Good Manufacturing Practices (GMP) certification from Sri Lanka Standards Institution can be found. All those millers are small quantity rice exporters. Priority should be given for the Small and medium scale millers in distribution of storage paddy of PMB during the off season. The industry needs a proper rice grading system, and it is recommended to introduce a ceiling price based on graded rice according to the standards. Both husk and rice bran were underutilized. Encouraging investment for establishing rice oil manufacturing plant in Polonnaruwa area is highly recommended. The current taxation procedure needs to be restructured in order to ensure the sustainability of the industry.Keywords: conduct, performance, structure (SCP), rice millers
Procedia PDF Downloads 3284259 Characteristics of Phytophthora infestans: The Causal Fungus of Potato Late Blight Disease
Authors: A. E. Elkorany, Eman Elsrgawy
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Eighty six isolates of Phytophthora infestans dating back to 2006 were recovered from potato tubers that were on sale in Alexandria markets, Egypt. The isolates were characterized for mating type and colony morphology. Both A1 and A2 mating types were detected in the isolate collection, however, the A2 constituted 5.8% of the total isolates made while the A1 mating type isolates constituted 91.9%. The self-fertile phenotype was also detected but at a lower percentage of 2.3% of the total isolates. This indicated that Mexico, the probable origin of the disease, is no longer the only place where A2 mating type ever exists. The lumpy phenotype was the only trait observed linked to the A2 mating type isolates on rye A agar medium. The self-fertile isolates, however, exhibited colonies of a waxy appearance with little aerial hyphae and the culture were backed full with oospores. The A1 mating colonies were of smooth white abundant aerial hyphae. The metalaxyl resistant isolates were also detected among the analyzed isolates and constituted 4.6% of the total (86) isolates investigated. The appearance of the A2 mating type outside Mexico and the variation revealed in the population of Phytophthora infestans investigated supported the hypothesis of a second worldwide migration of the fungus from its origin which could constitute a threat to potato cultivation around the world.Keywords: Phytophthora infestans, potato, Egypt, fungus
Procedia PDF Downloads 3844258 The Impact of Ultrasonicator on the Vertical and Horizontal Mixing Profile of Petrol-Bioethanol
Authors: D. Nkazi, S. E. Iyuke, J. Mulopo
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Increasing global energy demand as well as air quality concerns have in recent years led to the search for alternative clean fuels to replace fossil fuels. One such alternative is the blending of petrol with ethanol, which has numerous advantages such ethanol’s ability to act as oxygenate thus reducing the carbon monoxide emissions from the exhaust of internal combustion engines of vehicles. However, the hygroscopic nature of ethanol is a major concern in obtaining a perfectly homogenized petrol-ethanol fuel. This problem has led to the study of ways of homogenizing the petrol-ethanol mixtures. During the blending process, volumes fraction of ethanol and petrol were studied with respect to the depth within the storage container to confirm homogenization of the blend and time of storage. The results reveal that the density of the mixture was constant. The binodal curve of the ternary diagram shows an increase of homogeneous region, indicating an improved of interaction between water and petrol. The concentration distribution in the reactor showed proof of cavitation formation since in both directions, the variation of concentration with both time and distance was found to be oscillatory. On comparing the profiles in both directions, the concentration gradient, diffusion flux, and energy and diffusion rates were found to be higher in the vertical direction compared to the horizontal direction. It was therefore concluded that ultrasonication creates cavitation in the mixture which enhances mass transfer and mixing of ethanol and petrol. The horizontal direction was found to be the diffusion rate limiting step which proposed that the blender should have a larger height to diameter ratio. It is, however, recommended that further studies be done on the rate-limiting step so as to have actual dimensions of the reactor.Keywords: ultrasonication, petrol, ethanol, concentration
Procedia PDF Downloads 3654257 Synthesis of New Anti-Tuberculosis Drugs
Authors: M. S. Deshpande, Snehal D. Bomble
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Tuberculosis (TB) is a deadly contagious disease that is caused by a bacterium called Mycobacterium tuberculosis. More than sixty years ago, the introduction of the first anti-TB drugs for the treatment of TB (streptomycin (STR), p-aminosalcylic acid (PAS), isoniazid (INH), and then later ethambutol (EMB) and rifampicin (RIF)) gave optimism to the medical community, and it was believed that the disease would be completely eradicated soon. Worldwide, the number of TB cases has continued to increase, but the incidence rate has decreased since 2003. Recently, highly drug-resistant forms of TB have emerged worldwide. The prolonged use of classical drugs developed a growing resistance and these drugs have gradually become less effective and incapable to meet the challenges, especially those of multi drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB, and HIV-TB co-infections. There is an unmet medical need to discover newer synthetic molecules and new generation of potent drugs for the treatment of tuberculosis which will shorten the time of treatment, be potent and safe while effective facing resistant strains and non-replicative, latent forms, reduce adverse side effect and not interfere in the antiretroviral therapy. This paper attempts to bring out the review of anti-TB drugs, and presents a novel method of synthesizing new anti-tuberculosis drugs and potential compounds to overcome the bacterial resistance and combat the re-emergence of tuberculosis.Keywords: tuberculosis, mycobacterium, multi-drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB
Procedia PDF Downloads 3804256 An Approach for Estimation in Hierarchical Clustered Data Applicable to Rare Diseases
Authors: Daniel C. Bonzo
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Practical considerations lead to the use of unit of analysis within subjects, e.g., bleeding episodes or treatment-related adverse events, in rare disease settings. This is coupled with data augmentation techniques such as extrapolation to enlarge the subject base. In general, one can think about extrapolation of data as extending information and conclusions from one estimand to another estimand. This approach induces hierarchichal clustered data with varying cluster sizes. Extrapolation of clinical trial data is being accepted increasingly by regulatory agencies as a means of generating data in diverse situations during drug development process. Under certain circumstances, data can be extrapolated to a different population, a different but related indication, and different but similar product. We consider here the problem of estimation (point and interval) using a mixed-models approach under an extrapolation. It is proposed that estimators (point and interval) be constructed using weighting schemes for the clusters, e.g., equally weighted and with weights proportional to cluster size. Simulated data generated under varying scenarios are then used to evaluate the performance of this approach. In conclusion, the evaluation result showed that the approach is a useful means for improving statistical inference in rare disease settings and thus aids not only signal detection but risk-benefit evaluation as well.Keywords: clustered data, estimand, extrapolation, mixed model
Procedia PDF Downloads 136