Search results for: UK Acute kidney injury
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2119

Search results for: UK Acute kidney injury

379 Clinical Evidence of the Efficacy of ArtiCovid (Artemisia Annua Extract) on Covid-19 Patients in DRC

Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

Abstract:

The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

Procedia PDF Downloads 120
378 Disentangling the Sources and Context of Daily Work Stress: Study Protocol of a Comprehensive Real-Time Modelling Study Using Portable Devices

Authors: Larissa Bolliger, Junoš Lukan, Mitja Lustrek, Dirk De Bacquer, Els Clays

Abstract:

Introduction and Aim: Chronic workplace stress and its health-related consequences like mental and cardiovascular diseases have been widely investigated. This project focuses on the sources and context of psychosocial daily workplace stress in a real-world setting. The main objective is to analyze and model real-time relationships between (1) psychosocial stress experiences within the natural work environment, (2) micro-level work activities and events, and (3) physiological signals and behaviors in office workers. Methods: An Ecological Momentary Assessment (EMA) protocol has been developed, partly building on machine learning techniques. Empatica® wristbands will be used for real-life detection of stress from physiological signals; micro-level activities and events at work will be based on smartphone registrations, further processed according to an automated computer algorithm. A field study including 100 office-based workers with high-level problem-solving tasks like managers and researchers will be implemented in Slovenia and Belgium (50 in each country). Data mining and state-of-the-art statistical methods – mainly multilevel statistical modelling for repeated data – will be used. Expected Results and Impact: The project findings will provide novel contributions to the field of occupational health research. While traditional assessments provide information about global perceived state of chronic stress exposure, the EMA approach is expected to bring new insights about daily fluctuating work stress experiences, especially micro-level events and activities at work that induce acute physiological stress responses. The project is therefore likely to generate further evidence on relevant stressors in a real-time working environment and hence make it possible to advise on workplace procedures and policies for reducing stress.

Keywords: ecological momentary assessment, real-time, stress, work

Procedia PDF Downloads 161
377 Examining the Effects of Increasing Lexical Retrieval Attempts in Tablet-Based Naming Therapy for Aphasia

Authors: Jeanne Gallee, Sofia Vallila-Rohter

Abstract:

Technology-based applications are increasingly being utilized in aphasia rehabilitation as a means of increasing intensity of treatment and improving accessibility to treatment. These interactive therapies, often available on tablets, lead individuals to complete language and cognitive rehabilitation tasks that draw upon skills such as the ability to name items, recognize semantic features, count syllables, rhyme, and categorize objects. Tasks involve visual and auditory stimulus cues and provide feedback about the accuracy of a person’s response. Research has begun to examine the efficacy of tablet-based therapies for aphasia, yet much remains unknown about how individuals interact with these therapy applications. Thus, the current study aims to examine the efficacy of a tablet-based therapy program for anomia, further examining how strategy training might influence the way that individuals with aphasia engage with and benefit from therapy. Individuals with aphasia are enrolled in one of two treatment paradigms: traditional therapy or strategy therapy. For ten weeks, all participants receive 2 hours of weekly in-house therapy using Constant Therapy, a tablet-based therapy application. Participants are provided with iPads and are additionally encouraged to work on therapy tasks for one hour a day at home (home logins). For those enrolled in traditional therapy, in-house sessions involve completing therapy tasks while a clinician researcher is present. For those enrolled in the strategy training group, in-house sessions focus on limiting cue use in order to maximize lexical retrieval attempts and naming opportunities. The strategy paradigm is based on the principle that retrieval attempts may foster long-term naming gains. Data have been collected from 7 participants with aphasia (3 in the traditional therapy group, 4 in the strategy training group). We examine cue use, latency of responses and accuracy through the course of therapy, comparing results across group and setting (in-house sessions vs. home logins).

Keywords: aphasia, speech-language pathology, traumatic brain injury, language

Procedia PDF Downloads 203
376 Robotic Exoskeleton Response During Infant Physiological Knee Kinematics

Authors: Breanna Macumber, Victor A. Huayamave, Emir A. Vela, Wangdo Kim, Tamara T. Chamber, Esteban Centeno

Abstract:

Spina bifida is a type of neural tube defect that affects the nervous system and can lead to problems such as total leg paralysis. Treatment requires physical therapy and rehabilitation. Robotic exoskeletons have been used for rehabilitation to train muscle movement and assist in injury recovery; however, current models focus on the adult populations and not on the infant population. The proposed framework aims to couple a musculoskeletal infant model with a robotic exoskeleton using vacuum-powered artificial muscles to provide rehabilitation to infants affected by spina bifida. The study that drove the input values for the robotic exoskeleton used motion capture technology to collect data from the spontaneous kicking movement of a 2.4-month-old infant lying supine. OpenSim was used to develop the musculoskeletal model, and Inverse kinematics was used to estimate hip joint angles. A total of 4 kicks (A, B, C, D) were selected, and the selection was based on range, transient response, and stable response. Kicks had at least 5° of range of motion with a smooth transient response and a stable period. The robotic exoskeleton used a Vacuum-Powered Artificial Muscle (VPAM) the structure comprised of cells that were clipped in a collapsed state and unclipped when desired to simulate infant’s age. The artificial muscle works with vacuum pressure. When air is removed, the muscle contracts and when air is added, the muscle relaxes. Bench testing was performed using a 6-month-old infant mannequin. The previously developed exoskeleton worked really well with controlled ranges of motion and frequencies, which are typical of rehabilitation protocols for infants suffering with spina bifida. However, the random kicking motion in this study contained high frequency kicks and was not able to accurately replicate all the investigated kicks. Kick 'A' had a greater error when compared to the other kicks. This study has the potential to advance the infant rehabilitation field.

Keywords: musculoskeletal modeling, soft robotics, rehabilitation, pediatrics

Procedia PDF Downloads 118
375 Neonatal Subcutaneous Fat Necrosis with Severe Hypercalcemia: Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

Procedia PDF Downloads 58
374 Chemical Synthesis, Characterization and Dose Optimization of Chitosan-Based Nanoparticles of MCPA for Management of Broad-Leaved Weeds (Chenopodium album, Lathyrus aphaca, Angalis arvensis and Melilotus indica) of Wheat

Authors: Muhammad Ather Nadeem, Bilal Ahmad Khan, Tasawer Abbas

Abstract:

Nanoherbicides utilize nanotechnology to enhance the delivery of biological or chemical herbicides using combinations of nanomaterials. The aim of this research was to examine the efficacy of chitosan nanoparticles containing MCPA herbicide as a potential eco-friendly alternative for weed control in wheat crops. Scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), and ultraviolet absorbance were used to analyze the developed nanoparticles. The SEM analysis indicated that the average size of the particles was 35 nm, forming clusters with a porous structure. Both nanoparticles of fluroxyper + MCPA exhibited maximal absorption peaks at a wavelength of 320 nm. The compound fluroxyper +MCPA has a strong peak at a 2θ value of 30.55°, which correlates to the 78 plane of the anatase phase. The weeds, including Chenopodium album, Lathyrus aphaca, Angalis arvensis, and Melilotus indica, were sprayed with the nanoparticles while they were in the third or fourth leaf stage. There were seven distinct dosages used: doses (D0 (Check weeds), D1 (Recommended dose of traditional herbicide, D2 (Recommended dose of Nano-herbicide (NPs-H)), D3 (NPs-H with 05-fold lower dose), D4 ((NPs-H) with 10-fold lower dose), D5 (NPs-H with 15-fold lower dose), and D6 (NPs-H with 20-fold lower dose)). The chitosan-based nanoparticles of MCPA at the prescribed dosage of conventional herbicide resulted in complete death and visual damage, with a 100% fatality rate. The dosage that was 5-fold lower exhibited the lowest levels of plant height (3.95 cm), chlorophyll content (5.63%), dry biomass (0.10 g), and fresh biomass (0.33 g) in the broad-leaved weed of wheat. The herbicide nanoparticles, when used at a dosage 10-fold lower than that of conventional herbicides, had a comparable impact on the prescribed dosage. Nano-herbicides have the potential to improve the efficiency of standard herbicides by increasing stability and lowering toxicity.

Keywords: mortality, visual injury, chlorophyl contents, chitosan-based nanoparticles

Procedia PDF Downloads 65
373 Carl Wernicke and the Origin of Neurolinguistics in Breslau: A Case Study in the Domain of the History of Linguistics

Authors: Aneta Daniel

Abstract:

The subject of the study is the exploration of the origins and dynamics of the development of language studies, which have been labelled as neurolinguistics. It is worth mentioning that the origins of neurolinguistics are to be found in the research conducted by German scientists before the Second World War in Breslau Universität (presently Wroclaw). The dominant figure in these studies was professor Carl Wernicke, whose students continued and creatively developed projects of their master within this area. Professor Carl Wernicke, a German physician, anatomist, psychiatrist, and neuropathologist, is primarily known for his influential research on aphasia. His research, as well as those conducted by professor Paul Broca, has led to breakthroughs in the location of brain functions, particularly speech. Years later the theses of the pioneers of cognitive neurology (Carl Wernicke and Paul Broca) were developed by other neurolinguists. The main objective of the investigation is the reconstruction of the group of scientists –the students of Carl Wernicke– who contributed to the development of neurolinguistics. The scholars were mainly neurologists and psychiatrists and dealt with the branch of science that had not been named neurolinguistics at that time. The profiles of the scholars will be analysed and presented as the members of the group of researchers who have contributed to the breakthroughs in psychology and neuroscience. The research material consists of archival records documenting the research of professor Carl Wernicke and the researchers from Breslau (presently Wroclaw) which is one of the fastest growing cities in Europe. In 1870, when Carl Wernicke became the medical doctor, Breslau was full of cultural events: festivals and circus shows were held in the city center. Today we can come back to these events due to 'Breslauer Zeitung (1870)', which precisely describes all the events that took place on particular days. It is worth noting that those were the beginnings of antisemitism in Breslau. Many theses and articles that have survived in the libraries in Wroclaw and all over the world contribute to the development of neuroscience. The history of research on the brain and speech analysis, including the history of psychology and neuroscience, areas from which neurolinguistics is derived, will be presented.

Keywords: Aphasia, brain injury, Carl Wernicke, language, neurolinguistics

Procedia PDF Downloads 393
372 Rare Diagnosis in Emergency Room: Moyamoya Disease

Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

Abstract:

Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

Procedia PDF Downloads 267
371 Antimicrobial Effects and Phytochemical Analysis of Chrysophyllum Albidum Plant Parts (Leaves, Roots and Seeds) Extracts on Bacterial Isolates from Urinary Catheters

Authors: Ebere Christian Ugochukwu, Okafor Josephine, Oyawoye Tomisin

Abstract:

The occurrence of multidrug resistance patterns that have been developed by bacteria has made it difficult to properly treat infections using standard clinical medications. Hence, the use of herbs as an alternative source of therapy is considered cheap and easily accessible to locals. This research explored the antimicrobial effects of aqueous and ethanolic extracts obtained from Chrysophyllum albidum (commonly called ‘Agbalumo’ in southwest Nigeria and ‘Udara’ in the eastern and southern parts of Nigeria) plant parts (leaves, roots and seeds) against bacteria isolated from urinary catheter tips. The following isolates were obtained; Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Proteus mirabilis, and Klebsiella aerogenes. The agar well diffusion method was used. The average percentages of antimicrobial resistance of the isolates to gentamycin were 45.5% for P. aeruginosa, 42.1% for E. coli, 46.9% for K. aerogenes, and ˃90% for other isolates. Qualitative phytochemical screening of the plant parts extracts was done using chemical test for the screening and identification of bioactive chemical constituents. The ethanolic extract mixtures (leaf, root and seed) had the greatest effect on all the isolates, with inhibition zones (IZs) ranging from 8-26 mm and MICs ranging from <16-32 mg/ml. The Potencies of the C. albidum extracts based on the IZ and MIC values were greater in the extract mixtures, followed by those in the roots. Phytochemical screening revealed that all the extracts contained phenol except for the seeds while tannins were present in all the extracts except the leaves. The activity of the ethanolic extracts of each part at high and low concentrations was greater than that of the aqueous extracts at the same concentrations (p<0.05). The acute toxicity results showed that the LD50 of the extracts was ˃5000 mg/body weight, indicating no toxicity. The antibacterial activities of the extract mixtures and roots on the isolates confirmed the use of C. albidum in folk medicine for the treatment of CAUTIs, hence indicating its antibacterial potential for use in novel antibiotic production.

Keywords: antimicrobials, susceptibility, minimum inhibitory concentration, extracts

Procedia PDF Downloads 29
370 An Electrochemical Enzymatic Biosensor Based on Multi-Walled Carbon Nanotubes and Poly (3,4 Ethylenedioxythiophene) Nanocomposites for Organophosphate Detection

Authors: Navpreet Kaur, Himkusha Thakur, Nirmal Prabhakar

Abstract:

The most controversial issue in crop production is the use of Organophosphate insecticides. This is evident in many reports that Organophosphate (OP) insecticides, among the broad range of pesticides are mainly involved in acute and chronic poisoning cases. OPs detection is of crucial importance for health protection, food and environmental safety. In our study, a nanocomposite of poly (3,4 ethylenedioxythiophene) (PEDOT) and multi-walled carbon nanotubes (MWCNTs) has been deposited electrochemically onto the surface of fluorine doped tin oxide sheets (FTO) for the analysis of malathion OP. The -COOH functionalization of MWCNTs has been done for the covalent binding with amino groups of AChE enzyme. The use of PEDOT-MWCNT films exhibited an excellent conductivity, enables fast transfer kinetics and provided a favourable biocompatible microenvironment for AChE, for the significant malathion OP detection. The prepared biosensors were characterized by Fourier transform infrared spectrometry (FTIR), Field emission-scanning electron microscopy (FE-SEM) and electrochemical studies. Various optimization studies were done for different parameters including pH (7.5), AChE concentration (50 mU), substrate concentration (0.3 mM) and inhibition time (10 min). Substrate kinetics has been performed and studied for the determination of Michaelis Menten constant. The detection limit for malathion OP was calculated to be 1 fM within the linear range 1 fM to 1 µM. The activity of inhibited AChE enzyme was restored to 98% of its original value by 2-pyridine aldoxime methiodide (2-PAM) (5 mM) treatment for 11 min. The oxime 2-PAM is able to remove malathion from the active site of AChE by means of trans-esterification reaction. The storage stability and reusability of the prepared biosensor is observed to be 30 days and seven times, respectively. The application of the developed biosensor has also been evaluated for spiked lettuce sample. Recoveries of malathion from the spiked lettuce sample ranged between 96-98%. The low detection limit obtained by the developed biosensor made them reliable, sensitive and a low cost process.

Keywords: PEDOT-MWCNT, malathion, organophosphates, acetylcholinesterase, biosensor, oxime (2-PAM)

Procedia PDF Downloads 444
369 Effect of Plant Growth Regulators on in vitro Biosynthesis of Antioxidative Compounds in Callus Culture and Regenerated Plantlets Derived from Taraxacum officinale

Authors: Neha Sahu, Awantika Singh, Brijesh Kumar, K. R. Arya

Abstract:

Taraxacum officinale Weber or dandelion (Asteraceae) is an important Indian traditional herb used to treat liver detoxification, digestive problems, spleen, hepatic and kidney disorders, etc. The plant is well known to possess important phenolic and flavonoids to serve as a potential source of antioxidative and chemoprotective agents. Biosynthesis of bioactive compounds through in vitro cultures is a requisite for natural resource conservation and to provide an alternative source for pharmaceutical applications. Thus an efficient and reproducible protocol was developed for in vitro biosynthesis of bioactive antioxidative compounds from leaf derived callus and in vitro regenerated cultures of Taraxacum officinale using MS media fortified with various combinations of auxins and cytokinins. MS media containing 0.25 mg/l 2, 4-D (2, 4-Dichloro phenoxyacetic acid) with 0.05 mg/l 2-iP [N6-(2-Isopentenyl adenine)] was found as an effective combination for the establishment of callus with 92 % callus induction frequency. Moreover, 2.5 mg/l NAA (α-Naphthalene acetic acid) with 0.5 mg/l BAP (6-Benzyl aminopurine) and 1.5 mg/l NAA showed the optimal response for in vitro plant regeneration with 80 % regeneration frequency and rooting respectively. In vitro regenerated plantlets were further transferred to soil and acclimatized. Quantitative variability of accumulated bioactive compounds in cultures (in vitro callus, plantlets and acclimatized) were determined through UPLC-MS/MS (ultra-performance liquid chromatography-triple quadrupole-linear ion trap mass spectrometry) and compared with wild plants. The phytochemical determination of in vitro and wild grown samples showed the accumulation of 6 compounds. In in vitro callus cultures and regenerated plantlets, two major antioxidative compounds i.e. chlorogenic acid (14950.0 µg/g and 4086.67 µg/g) and umbelliferone (10400.00 µg/g and 2541.67 µg/g) were found respectively. Scopoletin was found to be highest in vitro regenerated plants (83.11 µg/g) as compared to wild plants (52.75 µg/g). Notably, scopoletin is not detected in callus and acclimatized plants, but quinic acid (6433.33 µg/g) and protocatechuic acid (92.33 µg/g) were accumulated at the highest level in acclimatized plants as compared to other samples. Wild grown plants contained highest content (948.33 µg/g) of flavonoid glycoside i.e. luteolin-7-O-glucoside. Our data suggests that in vitro callus and regenerated plants biosynthesized higher content of antioxidative compounds in controlled conditions when compared to wild grown plants. These standardized cultural conditions may be explored as a sustainable source of plant materials for enhanced production and adequate supply of oxidative polyphenols.

Keywords: anti-oxidative compounds, in vitro cultures, Taraxacum officinale, UPLC-MS/MS

Procedia PDF Downloads 201
368 Exoskeleton Response During Infant Physiological Knee Kinematics And Dynamics

Authors: Breanna Macumber, Victor A. Huayamave, Emir A. Vela, Wangdo Kim, Tamara T. Chamber, Esteban Centeno

Abstract:

Spina bifida is a type of neural tube defect that affects the nervous system and can lead to problems such as total leg paralysis. Treatment requires physical therapy and rehabilitation. Robotic exoskeletons have been used for rehabilitation to train muscle movement and assist in injury recovery; however, current models focus on the adult populations and not on the infant population. The proposed framework aims to couple a musculoskeletal infant model with a robotic exoskeleton using vacuum-powered artificial muscles to provide rehabilitation to infants affected by spina bifida. The study that drove the input values for the robotic exoskeleton used motion capture technology to collect data from the spontaneous kicking movement of a 2.4-month-old infant lying supine. OpenSim was used to develop the musculoskeletal model, and Inverse kinematics was used to estimate hip joint angles. A total of 4 kicks (A, B, C, D) were selected, and the selection was based on range, transient response, and stable response. Kicks had at least 5° of range of motion with a smooth transient response and a stable period. The robotic exoskeleton used a Vacuum-Powered Artificial Muscle (VPAM) the structure comprised of cells that were clipped in a collapsed state and unclipped when desired to simulate infant’s age. The artificial muscle works with vacuum pressure. When air is removed, the muscle contracts and when air is added, the muscle relaxes. Bench testing was performed using a 6-month-old infant mannequin. The previously developed exoskeleton worked really well with controlled ranges of motion and frequencies, which are typical of rehabilitation protocols for infants suffering with spina bifida. However, the random kicking motion in this study contained high frequency kicks and was not able to accurately replicate all the investigated kicks. Kick 'A' had a greater error when compared to the other kicks. This study has the potential to advance the infant rehabilitation field.

Keywords: musculoskeletal modeling, soft robotics, rehabilitation, pediatrics

Procedia PDF Downloads 83
367 Half Dose Tissue Plasminogen Activator for Intermediate-Risk Pulmonary Embolism

Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

Abstract:

Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

Procedia PDF Downloads 75
366 Preliminary Short-Term Results of a Population of Patients Treated with Mitraclip Therapy: One Center Experience

Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

Abstract:

Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

Procedia PDF Downloads 295
365 Visibility of the Borders of the Mandibular Canal: A Comparative in Vitro Study Using Digital Panoramic Radiography, Reformatted Panoramic Radiography and Cross Sectional Cone Beam Computed Tomography

Authors: Keerthilatha Pai, Sakshi Kamra

Abstract:

Objectives: Determining the position of the mandibular canal prior to implant placement and surgeries of the posterior mandible are important to avoid the nerve injury. The visibility of the mandibular canal varies according to the imaging modality. Although panoramic radiography is the most common, slowly cone beam computed tomography is replacing it. This study was conducted with an aim to determine and compare the visibility of superior and inferior borders of the mandibular canal in digital panoramic radiograph, reformatted panoramic radiograph and cross-sectional images of cone beam computed tomography. Study design: digital panoramic, reformatted panoramic radiograph and cross sectional CBCT images of 25 human mandibles were evaluated for the visibility of the superior and inferior borders of the mandibular canal according to a 5 point scoring criteria. Also, the canal was evaluated as completely visible, partially visible and not visible. The mean scores and visibility percentage of all the imaging modalities were determined and compared. The interobserver and intraobserver agreement in the visualization of the superior and inferior borders of the mandibular canal were determined. Results: The superior and inferior borders of the mandibular canal were completely visible in 47% of the samples in digital panoramic, 63% in reformatted panoramic and 75.6% in CBCT cross-sectional images. The mandibular canal was invisible in 24% of samples in digital panoramic, 19% in reformatted panoramic and 2% in cross-sectional CBCT images. Maximum visibility was seen in Zone 5 and least visibility in Zone 1. On comparison of all the imaging modalities, CBCT cross-sectional images showed better visibility of superior border in Zones 2,3,4,6 and inferior border in Zones 2,3,4,6. The difference was statistically significant. Conclusion: CBCT cross-sectional images were much superior in the visualization of the mandibular canal in comparison to reformatted and digital panoramic radiographs. The inferior border was better visualized in comparison to the superior border in digital panoramic imaging. The mandibular canal was maximumly visible in posterior one-third region of the mandible and the visibility decreased towards the mental foramen.

Keywords: cone beam computed tomography, mandibular canal, reformatted panoramic radiograph, visualization

Procedia PDF Downloads 127
364 Therapeutic Effects of Guar Gum Nanoparticles in Oxazolone-Induced Atopic Dermatitis

Authors: Nandita Ghosh, Shinjini Mitra, Ena Ray Banerjee

Abstract:

Atopic dermatitis (AD) is a chronic disease of the skin, involving itchy, reddish, and scaly lesions. It mainly affects children and has a high prevalence in developing countries. The AD may occur due to environmental or genetic factors. There is no permanent cure for the AD. Currently, all therapeutic strategies involve methods to simply alleviate the symptoms, and include lotions and corticosteroids, which have adverse effects. Use of phytochemicals and natural products has not yet been exploited fully. The particle used in this study is derived from Cyamopsis tetragonoloba, an edible polysaccharide with a galactomannan component. The mannose component mainly increases its specificity towards cellular uptake by mannose receptors, highly expressed by the macrophage. The aim of this study was to determine the therapeutic effect of guar gum nanoparticles (GN) in vitro and in vivo in the AD. To assess the wound healing capacity of the guar gum nanoparticle (GN), we first treated adherent NIH3T3 cells, with a scratch injury, with GN. GN successfully healed the wound caused by the scratch. In the in vivo experiment, Balb/c mice ear were topically treated with oxazolone (oxa) to induce AD and then were topically treated with GN. The ear thickness was increased significantly till day 28 on the treatment of Oxa. The GN application showed a significant decrease in the thickness as assessed on day 28. The total cell count of skin cells showed fold increase when treated with oxa, was again decreased on topical application of GN on the affected skin. The eosinophil count, as assessed by Giemsa staining was also increased when treated with oxa, GN application led to a significant decrease. The IgE level was assessed in the serum samples which showed that GN helped in restoring the alleviated IgE level. The T helper cells and the macrophage population showed increased percentage when treated with oxa, the GN application. This was examined by flow cytometry. The H&E staining of the ear tissue showed epidermal thickness in the oxa treated mice, GN application showed reduced cellular filtration followed by epidermal thickness. Thus our assays showed that GN was successful in alleviating the disease caused by Oxa when administered topically.

Keywords: allergen, inflammation, nanodrug, wound

Procedia PDF Downloads 243
363 Effects of Kinesio Taping on Postural Stability in Young Soccer Players

Authors: Mustafa Gulsen, Nihan Pekyavas, Emine Atıcı

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Purpose: The aim of this study is to investigate the effects of Kinesio taping on postural stability and in young soccer players. Subjects and Methods: 62 volunteered soccer players from Cayyolu Sports Club were included in our study. Permissions were also taken from the club directors about the inclusion of their players to our study. Soccer players between the age of 12 and 16 were included in our study. Players that had previous injury on lower extremities were excluded from the study. Players were randomly divided into two groups: Kinesio taping (KT) (n=31), and control group (n = 31). KT application including gastrocnemius and quadriceps femoris muscle facilitation techniques were applied to the first group. A rest time for 45 minutes was given in order to see the best effectiveness of the tape. The second group was set as the control group and no application was made. All participants were assessed before the application and 45 minutes later. In order to provide the double-blind design of the study, an experienced physiotherapist has done the assessments and another experienced physiotherapist has done the taping. The patients were randomly assigned to one of the two groups using an online random allocation software program. Postural stability was assessed by using Tetrax Interactive Balance System. Thermographic assessment was done by using FLIR E5 (FLIR Systems AB, Sweden) thermal camera in order to see which muscles have the most thermal activity while maintaining postural stability. Results: Statistically significant differences were found in all assessment parameters in both Kinesio Taping and control groups (all p<0.05) except thermal imaging of dominant gastrocnemius muscle results (p=0.668) (Table 1). In comparison of the two groups, statistically significant differences were found in all parameters (all p<0.05). Conclusion: In this study, we investigated the effects of Kinesio taping on postural stability in young soccer players and found that KT application on Quadriceps and Gastrocnemius muscles may have decreased the risk of falling more than the control group. According to thermal imaging assessments, both Quadriceps and Gastrocnemius muscles may be active in maintaining postural stability but in KT group, the temperature of these muscles are higher which leads us to think that they are more activated.

Keywords: Kinesio taping, fall risk, muscle temperature, postural stability

Procedia PDF Downloads 241
362 Management Problems in a Patient With Long-term Undiagnosed Permanent Hypoparathyroidism

Authors: Babarina Maria, Andropova Margarita

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Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

Procedia PDF Downloads 108
361 Efficacy of Botulinum Toxin in Alleviating Pain Syndrome in Stroke Patients with Upper Limb Spasticity

Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

Procedia PDF Downloads 309
360 Poly(Acrylamide-Co-Itaconic Acid) Nanocomposite Hydrogels and Its Use in the Removal of Lead in Aqueous Solution

Authors: Majid Farsadrouh Rashti, Alireza Mohammadinejad, Amir Shafiee Kisomi

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Lead (Pb²⁺), a cation, is a prime constituent of the majority of the industrial effluents such as mining, smelting and coal combustion, Pb-based painting and Pb containing pipes in water supply systems, paper and pulp refineries, printing, paints and pigments, explosive manufacturing, storage batteries, alloy and steel industries. The maximum permissible limit of lead in the water used for drinking and domesticating purpose is 0.01 mg/L as advised by Bureau of Indian Standards, BIS. This becomes the acceptable 'safe' level of lead(II) ions in water beyond which, the water becomes unfit for human use and consumption, and is potential enough to lead health problems and epidemics leading to kidney failure, neuronal disorders, and reproductive infertility. Superabsorbent hydrogels are loosely crosslinked hydrophilic polymers that in contact with aqueous solution can easily water and swell to several times to their initial volume without dissolving in aqueous medium. Superabsorbents are kind of hydrogels capable to swell and absorb a large amount of water in their three-dimensional networks. While the shapes of hydrogels do not change extensively during swelling, because of tremendously swelling capacity of superabsorbent, their shape will broadly change.Because of their superb response to changing environmental conditions including temperature pH, and solvent composition, superabsorbents have been attracting in numerous industrial applications. For instance, water retention property and subsequently. Natural-based superabsorbent hydrogels have attracted much attention in medical pharmaceutical, baby diapers, agriculture, and horticulture because of their non-toxicity, biocompatibility, and biodegradability. Novel superabsorbent hydrogel nanocomposites were prepared by graft copolymerization of acrylamide and itaconic acid in the presence of nanoclay (laponite), using methylene bisacrylamide (MBA) and potassium persulfate, former as a crosslinking agent and the second as an initiator. The superabsorbent hydrogel nanocomposites structure was characterized by FTIR spectroscopy, SEM and TGA Spectroscopy adsorption of metal ions on poly (AAm-co-IA). The equilibrium swelling values of copolymer was determined by gravimetric method. During the adsorption of metal ions on polymer, residual metal ion concentration in the solution and the solution pH were measured. The effects of the clay content of the hydrogel on its metal ions uptake behavior were studied. The NC hydrogels may be considered as a good candidate for environmental applications to retain more water and to remove heavy metals.

Keywords: adsorption, hydrogel, nanocomposite, super adsorbent

Procedia PDF Downloads 187
359 A Prospective Audit to Look into Antimicrobial Prescribing in the Clinical Setting: In a Teaching Hospital in the UK

Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

Procedia PDF Downloads 303
358 Analysis of Financial Performance Measurement and Financial Distress Assessment of Highway Companies Listed on Indonesia Stock Exchange before and during COVID-19 Pandemic

Authors: Ari Prasetyo, Taufik Faturohman

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The COVID-19 pandemic in Indonesia is part of the ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was confirmed to have spread to Indonesia on 2 March 2020. Moreover, the government of Indonesia has been conducting a local lockdown to limit people's movement from one city to another city. Therefore, this situation has impact on business operation, especially on highway companies listed on the Indonesia stock exchange. This study evaluates and measures three companies’ financial performance and health conditions before and during the COVID-19 pandemic from 2016 – 2020. The measurement is conducted by using financial ratio analysis and the Altman Z-score method. The ratio used to measure the financial ratio analysis is taken from the decree of the Ministry of SOE’s KEP-100/MBU/2002 about the company’s health level condition. From the decree, there are eight financial ratios used such as return on equity (ROE), return on investment (ROI), current ratio, cash ratio, collection period, inventory turnover, total asset turnover, and total equity to total asset. Altman Z-score is used to calculate the financial distress condition. The result shows that the highway companies for the period 2016 – 2020 are as follows: PT Jasa Marga (Persero) Tbk (AA, BB, BB, BB, C), PT Citra Marga Nusaphala Persada Tbk (BB, AA, BB, BBB, C), and PT Nusantara Infrastructure Tbk (BB, BB, AA, BBB, C). In addition, the Altman Z-score assessment performed in 2016-2020 shows that PT Jasa Marga (Persero) Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020. PT Citra Marga Nusaphala Persada Tbk was in the grey zone area for 2015-2019 and in the distress zone for 2020. PT Nusantara Infrastructure Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020.

Keywords: financial performance, financial ratio, Altman Z-score, financial distress, highway company

Procedia PDF Downloads 191
357 Effect of Pulmonary Rehabilitation towards Length of Stay and IL-6 Level on Community-Acquired Pneumonia Patients

Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

Procedia PDF Downloads 102
356 Pressures of a Pandemic on the Perinatal Women: Experiences of Welsh Women

Authors: Filiz Celik, Rachel Harrad, Rob Keasley, Paul Bennett

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The COVID-19 pandemic has posed a significant challenge to many, with some groups with particular vulnerability to adverse psychological impacts. These include those disadvantaged by mental ill health, either pre-existing or occurring during pregnancy or post-partum. Using a qualitative approach, the research aimed to identify the challenges posed by COVID-19 to women, their infants and families during the perinatal period and to suggest what further support can help alleviate the adverse mental health impact of COVID-19. 21 expectant and new mothers who were currently receiving support via a peri-natal mental health service participated in semi-structured interviews. In these interviews, participants explored the impact of changes in social circumstances and healthcare providers as a result of COVID-19 restrictions, with the resultant audio recordings transcribed and analyzed using Reflexive Thematic Analysis (RTA). Based on these accounts, it was concluded that women, their partners and potentially their infants experienced heightened peri-natal distress, and their experience at this time increased their risk for future mental health problems. Women described emerging as more vulnerable, owing to their role as primary caregivers during the perinatal period and also explained how social isolation and limited access to services meant protective buffers against mental health deterioration were reduced and the resources they needed in order to develop resilience were weakened. Although partners were invited to take part in the research, a sizeable volume of data could not be generated to fully assess the impact of the pandemic on a partner’s mental well-being. However, women expressed concerns about the paternal mental health of partners and husbands which invites us to be further vigilant to paternal mental health and associated experiences. Overall, these interviews serve to highlight and provide a voice to these women and their families who describe experiencing disadvantage at an already vulnerable time in their lives, as well as illustrating the need for services to prioritize the needs of this population when acute events strike, be those future pandemics or other disasters.

Keywords: patient experience, perinatal mental health, covid-19 pandemic, heightened anxiety, birth trauma, post-natal well-being

Procedia PDF Downloads 69
355 Assessing the Prevalence of Accidental Iatrogenic Paracetamol Overdose in Adult Hospital Patients Weighing <50kg: A Quality Improvement Project

Authors: Elisavet Arsenaki

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Paracetamol overdose is associated with significant and possibly permanent consequences including hepatotoxicity, acute and chronic liver failure, and death. This quality improvement project explores the prevalence of accidental iatrogenic paracetamol overdose in hospital patients with a low body weight, defined as <50kg and assesses the impact of educational posters in trying to reduce it. The study included all adult inpatients on the admissions ward, a short stay ward for patients requiring 12-72 hour treatment, and consisted of three cycles. Each cycle consisted of 3 days of data collection in a given month (data collection for cycle 1 occurred in January 2022, February 2022 for cycle 2 and March 2022 for cycle 3). All patients given paracetamol had their prescribed dose checked against their charted weight to identify the percentage of adult inpatients <50kg who were prescribed 1g of paracetamol instead of 500mg. In the first cycle of the audit, data were collected from 83 patients who were prescribed paracetamol on the admissions ward. Subsequently, four A4 educational posters were displayed across the ward, on two separate occasions and with a one-month interval in between each poster display. The aim of this was to remind prescribing doctors of their responsibility to check patient body weight prior to prescribing paracetamol. Data were collected again one week after each round of poster display, from 72 and 70 patients respectively. Over the 3 cycles with a cumulative 225 patients, 15 weighed <50kg (6.67%) and of those, 5 were incorrectly prescribed 1g of paracetamol, yielding a 33.3% prevalence of accidental iatrogenic paracetamol overdose in adult inpatients. In cycle 1 of the project, 3 out of 6 adult patients weighing <50kg were overdosed on paracetamol, meaning that 50% of low weight patients were prescribed the wrong dose of paracetamol for their weight. In the second data collection cycle, 1 out of 5 <50kg patients were overdosed (20%) and in the third cycle, 1 out of 4 (25%). The use of educational posters resulted in a lower prevalence of accidental iatrogenic paracetamol overdose in low body weight adult inpatients. However, the differences observed were statistically insignificant (p value 0.993 and 0.995 respectively). Educational posters did not induce a significant decrease in the prevalence of accidental iatrogenic paracetamol overdose. More robust strategies need to be employed to further decrease paracetamol overdose in patients weighing <50kg.

Keywords: iatrogenic, overdose, paracetamol, patient, safety

Procedia PDF Downloads 112
354 Carbendazim Toxicity and Ameliorative Effect of Vitamin E in African Giant Rats

Authors: A. O. Omonona, T. A. Jarikre

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Increase specialization in agriculture and use of pesticides may inadvertently cause ecosystem degradation and eventually loss of biodiversity. The populations of numerous wildlife species have undergone a precipitous decline. Many of these problems have been attributed directly to habitat loss and over exploitation resulting from unregulated pesticide uses. Carbendazim a broad spectrum benzimidazole fungicide and a metabolite of benomyl, is used to control plant disease in cereals and fruit. The effect of carbendazim exposure and the ameliorative effect of tocopherol (vitamin E) were assessed on African giant rat AGR. Hematological, biochemical and histological changes were used to determine the health condition of the animals exposed to pesticide. Sixteen AGR were stabilized, weighed and then divided into four experimental groups (A to D). Two groups were pretreated with vitamin. Group A was exposed to carbendazim only, B- carbendazim + vitamin, C- vitamin only, and D- blank (control). Packed cell volume PCV was estimated by the microhematocrit method, Leucocyte and Platelet counts were determined using the hemocytometric method. Cholinesterase (AchE) and markers of oxidative stress were quantified, and tissue changes examined microscopically. There were no behavioral changes observed in the animals, but there was a decrease in body weight and abortion after 23 days of exposure to carbendazim. There was significant differences in the packed cell volume, the hemoglobin concentration and the red blood cell counts (p < 0.05). The increases in malonyl aldehyde MDA was significant (p < 0.05) in the pesticide intoxicated rats compared to control. Vitamin E supplementation reduced MDA level significantly (p < 0.05). There was a sharp remarkable decrease in acetylcholinesterase levels in the pesticide intoxicated rats (p < 0.05). Vitamin E supplementation normalise the AchE levels comparable to that in control. Grossly, the vital organs appeared normal in the pesticide exposed and control groups except moderate pulmonary congestion. Microscopically, there was severe diffuse hepatocellular swelling in carbendazim exposed group. The severity of hepatocellular injury was reduced in the rats with vitamin E. This study ascertained the toxic effect of carbendazim and antioxidative properties of vitamins in the Africa giant rat.

Keywords: African giant rat, antioxidant, carbendazim, pesticides, toxicity

Procedia PDF Downloads 363
353 Tablet Computer Based Cognitive Rehabilitation Program, Injini, for Children with Cognitive Impairment

Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Cognitive impairment is commonly encountered problem in children with various clinical diseases, including Down syndrome, autism spectrum disorder, brain injury, and others. Cognitive impairment limits participation in education and society, and this further hinders development in cognition. However, young children with cognitive impairment tend not to respond well to traditional cognitive treatments, therefore alternative treatment choices are need. As a cognitive training program, touch screen technology can easily be applied to very young children by involving visual and auditory support. Injini was developed as tablet computer based cognitive rehabilitation program for young children or individuals with severe cognitive impairment, which targeted on cognitive ages of 18 to 36 months. The aim of this study was to evaluate the efficacy of a tablet computer based cognitive rehabilitation program (Injini) for children with cognitive impairment. 38 children between cognitive ages of 18 to 36 months confirmed by cognitive evaluations were recruited and randomly assigned to the intervention group (n=20) and the control group (n=18). The intervention group received tablet computer based cognitive rehabilitation program (Injini) for 30 minutes per session, twice a week, over a period of 12 weeks, in addition to the traditional rehabilitation program. The control group received traditional rehabilitation program only. Mental score of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), Laboratory Temperament Assessment Battery (Lab-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. When comparing the baseline characteristics, there was no significant difference between the two groups in the measurements of cognitive function. After 12 weeks of treatment, both group showed improvements in all measurements. However, in comparison of improvements after treatment, the intervention group showed more improvements in the mental score of BSID II, social function domain of PEDI, observation domain of Lab-TAB, and GAS, as compared to the control group. Application of the tablet computer based cognitive rehabilitation program (Injini) would be beneficial for improvement of cognitive function in young children with cognitive impairment.

Keywords: cognitive therapy, computer-assisted therapy, early intervention, tablets

Procedia PDF Downloads 284
352 Study on Metabolic and Mineral Balance, Oxidative Stress and Cardiovascular Risk Factors in Type 2 Diabetic Patients on Different Therapy

Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca

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Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.

Keywords: cardiovascular risk, homocysteine, malondialdehyde, metformin, minerals, type 2 diabetes, vitamin B12

Procedia PDF Downloads 319
351 Ethanol Precipitation and Characterization of L-Asparaginase from Aspergillus oryzae

Authors: L. L. Tundisi, A. Pessoa Jr., E. B. Tambourgi, E. Silveira, P. G. Mazzola

Abstract:

L-asparaginase (L-ASNase) is the gold standard treatment for acute lymphoblastic leukemia that mainly affects pediatric patients; treatment increases survival from 20% to 90%. The characterization of other L-Asparaginases, apart from the most used from Escherichia coli and Erwinia chrysanthemi, has been reported, but the choice of the most appropriate is still under debate. This choice should be based on its pharmacokinetics, immune hypersensitivity, doses, prices, pharmacodynamics. The main factors influencing the antileukemic activity of ASNase are enzymatic activity, Km, glutaminase activity, clearance of the enzyme and development of resistance. However, most of the commercialized enzyme present an intrinsic glutaminase activity, which is responsible for some side effects. In this study, glutaminase free asparaginase produced from Aspergillus oryzae was precipitated in different percentages of ethanol (0–80%), until optimum ethanol concentration of 60% (w/w) was found. Following, precipitation of crude L-ASNase was performed in a single step, using 60% (w/w) ethanol, under constant agitation and temperature. It presented activity of 135.45 U/mg and after gel filtration chromatography with Sephadex G-the enzymatic activity was 322.02 U/mg. The apparent molecular mass of the purified L-ASNase fraction was estimated by 10% SDS-PAGE. Proteins were stained with Coomassie Brilliant Blue R-250. The molar mass range was from 10 kDa to 250 kDa. L-ASNase from Aspergillus oryzae was characterized aiming possible therapeutic use. Four different buffers (phosphate-citrate buffer pH 2.6 to 5.8; phosphate buffer pH 5.8 to 7.4; Tris - HCl pH 7.4 to 9.0; and carbonate buffer pH 9.8 to 10.6) were used to measure the optimum pH for L-ASNase activity. The optimum temperature for enzyme activity was measured at optimal pH conditions (Tris-HCl and phosphate buffer, pH 7.4) at different temperatures ranging from 5 to 55°C. All activities were calculated by quantifying the free ammonia, using the Nessler reagent. The kinetic parameters calculation, e.g. Michaelis-Menten constant (Km), maximum velocity (Vmax) and Hills coefficient (n), were performed by incubating the enzyme in different concentrations of the substrate at optimum conditions of pH and fitted on Hill’s equation. This glutaminase free asparaginase showed a low Km (3.39 mM and 3.81 mM) and enzymatic activity of 135.45 U/mg after precipitation with ethanol. After gel filtration chromatography it rose to 322.02 U/mg. Optimum activity was found between pH 5.8 - 9.0, best activity results with phosphate buffer pH 7.4 and Tris-HCl pH 7.4 and showed activity from 5°C to 55°C. These results indicate that L-ASNase from A. oryzae has the potential for human use.

Keywords: biopharmaceuticals, bioprocessing, bioproducts, biotechnology, enzyme activity, ethanol precipitation

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350 Human Health Risk Assessment of Mercury-Contaminated Soils in Alebediah Mining Community, Sudan

Authors: Ahmed Elwaleed, Huiho Jeong, Ali H. Abdelbagi, Nguyen Thi Quynh, Koji Arizono, Yasuhiro Ishibashi

Abstract:

Artisanal and small-scale gold mining (ASGM) poses substantial risks to both human health and the environment, particularly through contamination of soil, water, and air. Prolonged exposure to ASGM-contaminated soils can lead to acute or chronic mercury toxicity. This study assesses the human health risks associated with mercury-contaminated soils and tailings in the Alebediah mining community in Sudan. Soil samples were collected from various locations within Alebediah, including ASGM areas, farmlands, and residential areas, along with tailings samples commonly found within ASGM sites. The evaluation of potential health risks to humans included the computation of the estimated daily intake (AvDI), the hazard quotient (HQ), and the hazard index (HI) for both adults and children. The primary exposure route identified as potentially posing a significant health risk was the volatilization of mercury from tailings samples, where mercury concentrations reached up to 25.5 mg/kg. In contrast, other samples within the ASGM area showed elevated mercury levels but did not present significant health risks, with HI values below 1. However, all areas indicated HI values above 1 for the remaining exposure routes. The study observed a decrease in mercury concentration with increasing distance from the ASGM community. Additionally, soil samples revealed elevated mercury levels exceeding background values, prompting an assessment of contamination levels using the enrichment factor (EF). The findings indicated that farmlands and residential areas exhibited depleted EF, while areas surrounding the ASGM community showed none to moderate pollution. In contrast, ASGM areas exhibited significant to extreme pollution. A GIS map was generated to visually depict the extent of mercury pollution, facilitating communication with stakeholders and decision-makers.

Keywords: mercury pollution, artisanal and small-scale gold mining, health risk assessment, hazard index, soil and tailings, enrichment factor

Procedia PDF Downloads 83