Search results for: low dose CT techniques
7961 Activities for Increasing Childhood Vaccination Coverage of the Refugee and Migrant Population, Greece, European Program PHILOS, 2017
Authors: C. Silvestros, K. Mellou, T. Georgakopoulou, A. Koustenis, E. Kokkinou, C. Botsi, A. Terzidis
Abstract:
'PHILOS – Emergency health response to refugee crisis' is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP) funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. One of the main objectives of the program is the immunization coverage of the target – population to assure the prevention of vaccine-preventable diseases. The program foresees vaccination needs assessment of children hosted at camps at the mainland and implementation of interventions to cover the vaccination gaps in co-operation with the Ministry of Health. The National Immunization Advisory Committee in Greece recommended that MMR (Measles, Mumps, and Rubella), PCV (Pneumococcal conjugate vaccine) and HEXA (diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b) vaccines should be performed in priority. Recording was completed at 24 camps (May - June 2017); 3381 children (0-18 years) were recorded. The median number of children hosted at each camp was 95 (range: 5-553). For 68% of the children, the WHO vaccination booklet was available. 44%, 48.5% and 61% of the children were vaccinated with at least one dose of PCV, HEXA, and MMR, respectively. The proportion of vaccinated children for the three vaccines mentioned above is significantly lower for the remaining doses; PCV (second dose 8%, third dose 1.3%), HEXA (second dose 13%, third dose 2.7%, forth dose 0.1%) and MMR (second dose 23%). None of the 37 (10 from Afghanistan, 3 from Bangladesh, 23 from Pakistan, 1 from Syria) recorded unaccompanied children did not have a WHO vaccination booklet and were considered unvaccinated. There is no differentiation in vaccination coverage among different ethnicities. Massive catch up vaccination was performed at 4 camps, and 671 vaccinations were performed (245 PCV, 307 HEXA, and 119 MMR). Similar interventions are planned for all camps of the country. Recording reveled gaps in vaccination coverage of the population, mainly because of the mobility of the population, the influx of refugees- which is still ongoing- and new births. Mass vaccination campaigns are considered vital in order to increase vaccination coverage, and continuous efforts are needed in order all children living at the camps to have full access to the National Childhood Immunization Program.Keywords: vaccine preventable, refugee–migrants camps, vaccination coverage, PCV, MMR, HEXA
Procedia PDF Downloads 1857960 Dosimetric Comparison of Conventional Plans versus Three Dimensional Conformal Simultaneously Integrated Boost Plans
Authors: Shoukat Ali, Amjad Hussain, Latif-ur-Rehman, Sehrish Inam
Abstract:
Radiotherapy plays an important role in the management of cancer patients. Approximately 50% of the cancer patients receive radiotherapy at one point or another during the course of treatment. The entire radiotherapy treatment of curative intent is divided into different phases, depending on the histology of the tumor. The established protocols are useful in deciding the total dose, fraction size, and numbers of phases. The objective of this study was to evaluate the dosimetric differences between the conventional treatment protocols and the three-dimensional conformal simultaneously integrated boost (SIB) plans for three different tumors sites (i.e. bladder, breast, and brain). A total of 30 patients with brain, breast and bladder cancers were selected in this retrospective study. All the patients were CT simulated initially. The primary physician contoured PTV1 and PTV2 in the axial slices. The conventional doses prescribed for brain and breast is 60Gy/30 fractions, and 64.8Gy/36 fractions for bladder treatment. For the SIB plans biological effective doses (BED) were calculated for 25 fractions. The two conventional (Phase I and Phase II) and a single SIB plan for each patient were generated on Eclipse™ treatment planning system. Treatment plans were compared and analyzed for coverage index, conformity index, homogeneity index, dose gradient and organs at risk doses.In both plans 95% of PTV volume received a minimum of 95% of the prescribe dose. Dose deviation in the optic chiasm was found to be less than 0.5%. There is no significant difference in lung V20 and heart V30 in the breast plans. In the rectum plans V75%, V50% and V25% were found to be less than 1.2% different. Deviation in the tumor coverage, conformity and homogeneity indices were found to be less than 1%. SIB plans with three dimensional conformal radiotherapy technique reduce the overall treatment time without compromising the target coverage and without increasing dose to the organs at risk. The higher dose per fraction may increase the late effects to some extent. Further studies are required to evaluate the late effects with the intention of standardizing the SIB technique for practical implementation.Keywords: coverage index, conformity index, dose gradient, homogeneity index, simultaneously integrated boost
Procedia PDF Downloads 4787959 Factors Associated with Ketamine Use in Pancreatic Cancer Patient in a Single Hospice Center
Authors: Kyung Min Kwom, Young Joo Lee
Abstract:
Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer
Procedia PDF Downloads 2357958 Determination of Natural Gamma Radioactivity in Sand along the Black Sea Coastal Region of Giresun, North Turkey
Authors: A. Karadeniz, Belgin Kucukomeroglu
Abstract:
In this study natural gamma radioactivity levels are determined on sands along the coastal regions of Giresun/Turkey. The coast of Giresun about 290 km long in investigated to collect 101 sand samples. Natural and artificial radioactivity concentrations of sand samples were measured by using HPGe gamma spectrometry. The average activity concentrations of 238U, 232Th, 40K and 137Cs on sand samples of Giresun were found to be 10.83±2.92 Bq/kg, 21.28±3.22 Bq/kg, 6.42±1.06 Bq/kg, 230.94±10.67 Bq/kg respectively. The average activity concentrations for these radionuclides were compared with the reported data of other parts of Turkey and other countries. The average absorbed dose rate for Giresun was calculated to be 38.68 nGy/h respectively. This value is significantly lower than the World averaged value of 60 nGy/h. The external annual effective dose rate concentration in Giresun was found to be 0.047 mSv/y respectively. This result is much lower than the recommeded limit of 5 mSv/y. The external hazard dose rate for Giresun weas calculated to be 0.21 respectively. This result is much lower than the recommended limit of 1.0.Keywords: concentration, radioactivity, Giresun, natural gamma radioactivity
Procedia PDF Downloads 3927957 Oral Antibiotics in Trans-Rectal Prostate Biopsy and Its Efficacy to Reduce Infectious Complications: Systematic Review
Authors: Mohand Yaghi, O. Kehinde
Abstract:
Background: For the diagnosis of prostate cancer Trans-rectal prostate biopsy (TRPB) is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx) decrease infective events after TRPB, but different regimens are used. Aim: To systematically review different regimens of prophylactic oral antibiotics in TRPB. Design: Medline, Embase, Clinical trials site, and Cochrane library were searched, experts were consulted about relevant studies. Randomized clinical trials (RCT) conducted in the last twenty years, which investigated different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Measurements: Primary outcomes were bacteriuria, urinary tract infection (UTI), fever, bacteremia, sepsis. Secondary outcomes were hospitalization rate, and the prevalence of ABx-resistant bacteria. Results: Nine trials were eligible with 3012 patients. Antibiotics prevented bacteriuria (3.5% vs. 9.88%), UTI (4.46% vs. 9.75%), and hospitalization (0.21% vs. 2.13%) significantly in comparison with placebo or no treatment. No significant difference was found in all outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple dose except in Bacteriuria (6.75% vs. 3.25%), and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%). Quinolones reduced only UTI significantly in comparison with other antibiotics. Lastly, Ciprofloxacin is the best Quinolone to prevent UTI, and hospitalization. Conclusion: it is essential to prescribe prophylactic Antibiotics in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria was identified more often in the single dose cohorts.Keywords: infection, prostate cancer, sepsis, TRPB
Procedia PDF Downloads 3687956 Estimation of Normalized Glandular Doses Using a Three-Layer Mammographic Phantom
Authors: Kuan-Jen Lai, Fang-Yi Lin, Shang-Rong Huang, Yun-Zheng Zeng, Po-Chieh Hsu, Jay Wu
Abstract:
The normalized glandular dose (DgN) estimates the energy deposition of mammography in clinical practice. The Monte Carlo simulations frequently use uniformly mixed phantom for calculating the conversion factor. However, breast tissues are not uniformly distributed, leading to errors of conversion factor estimation. This study constructed a three-layer phantom to estimated more accurate of normalized glandular dose. In this study, MCNP code (Monte Carlo N-Particles code) was used to create the geometric structure. We simulated three types of target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh), six voltages (25 ~ 35 kVp), six HVL parameters and nine breast phantom thicknesses (2 ~ 10 cm) for the three-layer mammographic phantom. The conversion factor for 25%, 50% and 75% glandularity was calculated. The error of conversion factors compared with the results of the American College of Radiology (ACR) was within 6%. For Rh/Rh, the difference was within 9%. The difference between the 50% average glandularity and the uniform phantom was 7.1% ~ -6.7% for the Mo/Mo combination, voltage of 27 kVp, half value layer of 0.34 mmAl, and breast thickness of 4 cm. According to the simulation results, the regression analysis found that the three-layer mammographic phantom at 0% ~ 100% glandularity can be used to accurately calculate the conversion factors. The difference in glandular tissue distribution leads to errors of conversion factor calculation. The three-layer mammographic phantom can provide accurate estimates of glandular dose in clinical practice.Keywords: Monte Carlo simulation, mammography, normalized glandular dose, glandularity
Procedia PDF Downloads 1907955 Anxieolytic Activity of Ethyl Acetate Extract of Flowers Nerium indicum
Authors: D. S. Mohale, A. V. Chandewar
Abstract:
Anxiety is defined as an exaggerated feeling of apprehension, uncertainty and fear. Nerium indicum is a well-known ornamental and medicinal plant belonging to the family Apocynaceae. A wide spectrum of biological activities has been reported with various constituents isolated from different parts of the plant. This study was conducted to investigate antianxiety activity of flower extract. Flowers were collected and dried in shade and coarsely powdered. Powdered mixture was extracted with ethyl acetate by maceration process. Extract of flowers obtained was subsequently dried in oven at 40-50 °C. This extract is then tested for antianxiety activity at low and high dose using Elevated Plus Maze and Light & dark Model. Rats shown increased open arm entries and time spent in open arm in elevated Plus maze with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. In Light & dark Model, light box entries and time spent in light box increased with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. From result it is concluded that Ethyl acetate extract of flower of Nerium indicum possess antianxiety activity at low and high dose.Keywords: anxiety, anxieolytic, social isolation, nerium indicum, kaner
Procedia PDF Downloads 3097954 Comparison of the Postoperative Analgesic Effects of Morphine, Paracetamol, and Ketorolac in Patient-Controlled Analgesia in the Patients Undergoing Open Cholecystectomy
Authors: Siamak Yaghoubi, Vahideh Rashtchi, Marzieh Khezri, Hamid Kayalha, Monadi Hamidfar
Abstract:
Background and objectives: Effective postoperative pain management in abdominal surgeries, which are painful procedures, plays an important role in reducing postoperative complications and increasing patient’s satisfaction. There are many techniques for pain control, one of which is Patient-Controlled Analgesia (PCA). The aim of this study was to compare the analgesic effects of morphine, paracetamol and ketorolac in the patients undergoing open cholecystectomy, using PCA method. Material and Methods: This randomized controlled trial was performed on 330 ASA (American Society of Anesthesiology) I-II patients ( three equal groups, n=110) who were scheduled for elective open cholecystectomy in Shahid Rjaee hospital of Qazvin, Iran from August 2013 until September 2015. All patients were managed by general anesthesia with TIVA (Total Intra Venous Anesthesia) technique. The control group received morphine with maximum dose of 0.02mg/kg/h, the paracetamol group received paracetamol with maximum dose of 1mg/kg/h, and the ketorolac group received ketorolac with maximum daily dose of 60mg using IV-PCA method. The parameters of pain, nausea, hemodynamic variables (BP and HR), pruritus, arterial oxygen desaturation, patient’s satisfaction and pain score were measured every two hours for 8 hours following operation in all groups. Results: There were no significant differences in demographic data between the three groups. there was a statistically significant difference with regard to the mean pain score at all times between morphine and paracetamol, morphine and ketorolac, and paracetamol and ketorolac groups (P<0.001). Results indicated a reduction with time in the mean level of postoperative pain in all three groups. At all times the mean level of pain in ketorolac group was less than that in the other two groups (p<0.001). Conclusion: According to the results of this study ketorolac is more effective than morphine and paracetamol in postoperative pain control in the patients undergoing open cholecystectomy, using PCA method.Keywords: analgesia, cholecystectomy, ketorolac, morphine, paracetamol
Procedia PDF Downloads 1977953 Application of Optimization Techniques in Overcurrent Relay Coordination: A Review
Authors: Syed Auon Raza, Tahir Mahmood, Syed Basit Ali Bukhari
Abstract:
In power system properly coordinated protection scheme is designed to make sure that only the faulty part of the system will be isolated when abnormal operating condition of the system will reach. The complexity of the system as well as the increased user demand and the deregulated environment enforce the utilities to improve system reliability by using a properly coordinated protection scheme. This paper presents overview of over current relay coordination techniques. Different techniques such as Deterministic Techniques, Meta Heuristic Optimization techniques, Hybrid Optimization Techniques, and Trial and Error Optimization Techniques have been reviewed in terms of method of their implementation, operation modes, nature of distribution system, and finally their advantages as well as the disadvantages.Keywords: distribution system, relay coordination, optimization, Plug Setting Multiplier (PSM)
Procedia PDF Downloads 3997952 The Use of Brachytherapy in the Treatment of Liver Metastases: A Systematic Review
Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska
Abstract:
Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT
Procedia PDF Downloads 1157951 Rituximab Therapy for Musculoskeletal Involvement in Systemic Sclerosis
Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva
Abstract:
Objectives. There is very few data on changes of the musculoskeletal manifestations (artritis, arthralgia, muscle weakness, etc.) in systemic sclerosis (SSc) on rituximab (RTX) therapy. The aim of our study was to assess the severity of the musculoskeletal involvement in SSc patients (pts) and its changes during RTX therapy. Methods. Our study included 103 pts with SSc. The mean followup period was 12.6±10.7 months. The mean age was 47±12.9 years, female-87 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had interstitial lung disease (ILD) and were positive for ANA, 67% of them were positive for antitopoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. Arthritis was observed in 22 pts (21%), arthralgias in 47 pts (46%). Muscle weakness was observed in 17 pts (17%). Tendon friction rubs was established in 7 pts (7%). The results at baseline and at the end of the follow up are presented in the form of mean values. Results. There was an improvement of all outcome parameters and musculoskeletal manifestations on RTX therapy. There was a decrease in the number of pts with arthritis from 22 (21%) to 10 (9%), a decrease in the number of pts with arthralgias from 47 (46%) to 31 (30%). The number of pts with muscle weakness decreased from 17 (17%) to 7 (7%). The number of pts with tendon friction rubs decreased from 7 (7%) to 3 (3%). The creatine phosphokinase decreased from 365.5±186 to 70.8±50.4 (p=0.00006). The C-reactive protein (CRP) decreased from 23.2±31.3 to 8.62±7.4 (p=0.001). The dose of prednisolone was reduced from 11.3±4.5 to 9.8±3.5 mg/day (p=0.0004). Conclusion. In our study, musculoskeletal involvement was detected in almost half of the patients with SSc-ILD. There was an improvement of musculoskeletal manifestations despite a small cumulative dose of RTX. We also managed to reduce the dose of glucocorticosteroids. The improvement of musculoskeletal manifestations was accompanied by a decrease in laboratory parameters - creatine phosphokinase and CRP. RTX is effective option for treatment of musculoskeletal manifestations in SSc.Keywords: arthritis, musculoskeletal involvement, systemic sclerosis, rituximab
Procedia PDF Downloads 827950 Genoprotective Effect of Lepidium sativum L. Seed Methanolic Extract on Cyclophosphamide-Induced DNA Damage in Mice and Characterization of Its Flavonoidal Content
Authors: Iman A. A. Kassem, Ayman A. Farghaly, Zeinab M. Hassan, Farouk R. Melek, Neveen S. Ghaly
Abstract:
Lipidium sativum L, an annual herb that grows to 50 cm, is known as an important member of family Brassicaceae. Besides its nutritional value, the seeds were widely used in folk medicine for treatment of cough, asthma, and headache. It was also reported to possess hypocholesterolemic, anti-inflammatory, antidiarrheal, antimicrobial and anticancer activities. In this study, the genoprotective properties of L. sativum seed methanolic extract (LSME) were evaluated in vivo. Three groups of mice were given LSME for five consecutive days at the three dose levels 25, 50 and 100 mg/kg b.wt. The three groups were then injected intraperitoneally with cyclophosphamide at a dose of 20 mg/kg b.wt. to induce DNA damage. A group received only cyclophosphamide (20 mg/kg b.wt.) served as control. LSME significantly inhibited the DNA aberrations in mice caused by cyclophosphamide in a dose-dependent manner in the two groups that received LSME at 50 and 100 mg/kg b.wt. dose levels. The chromosomal aberrations' inhibitory indices were calculated as 18 and 31 in mice bone marrow cells and 27 and 48 in mice spermatocytes, respectively. Phytochemical examination carried out by us revealed that flavonoids were the main chemical constituents of LSME. The major flavonoids kaempferol, kaempferol-3-O-rhamnoside, kaempferol-3-O-glucoside, quercetin, and quercetin-3-O-glucoside were isolated and characterized. It was concluded that the genoprotective effect of LSME might be attributed to the presence of flavonoids which are well-known for their antioxidant properties.Keywords: cyclophosphamide, flavonoids, genoprotective effect, Lepidium sativum
Procedia PDF Downloads 1587949 Efficacy of Single-Dose Azithromycin Therapy for the Treatment of Chlamydia trachomatis in Patients Evaluated for Child Sexual Abuse in an Urban Health Center 2006-16
Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann
Abstract:
Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms
Procedia PDF Downloads 2947948 Development of R³ UV Exposure for the UV Dose-Insensitive and Cost-Effective Fabrication of Biodegradable Polymer Microneedles
Authors: Sungmin Park, Gyungmok Nam, Seungpyo Woo, Young Choi, Sangheon Park, Sang-Hee Yoon
Abstract:
Puncturing human skin with microneedles is critically important for microneedle-mediate drug delivery. Despite of extensive efforts in the past decades, the scale-up fabrication of sharp-tipped and high-aspect-ratio microneedles, especially made of biodegradable polymers, is still a long way off. Here, we present a UV dose insensitive and cost-effective microfabrication method for the biodegradable polymer microneedles with sharp tips and long lengths which can pierce human skin with low insertion force. The biodegradable polymer microneedles are fabricated with the polymer solution casting where a poly(lactic-co-glycolic acid) (PLGA, 50:50) solution is coated onto a SU-8 mold prepared with a reverse, ramped, and rotational (R3) UV exposure. The R3 UV exposure is modified from the multidirectional UV exposure both to suppress UV reflection from the bottom surface without anti-reflection layers and to optimize solvent concentration in the SU-8 photoresist, therefore achieving robust (i.e., highly insensitive to UV dose) and cost-effective fabrication of biodegradable polymer microneedles. An optical model for describing the spatial distribution of UV irradiation dose of the R3 UV exposure is also developed to theoretically predict the microneedle geometry fabricated with the R3 UV exposure and also to demonstrate the insensitiveness of microneedle geometry to UV dose. In the experimental characterization, the microneedles fabricated with the R3 UV exposure are compared with those fabricated with a conventional method (i.e., multidirectional UV exposure). The R3 UV exposure-based microfabrication reduces the end-tip radius by a factor of 5.8 and the deviation from ideal aspect ratio by 74.8%, compared with conventional method-based microfabrication. The PLGA microneedles fabricated with the R3 UV exposure pierce full-thickness porcine skins successfully and are demonstrated to completely dissolve in PBS (phosphate-buffered saline). The findings of this study will lead to an explosive growth of the microneedle-mediated drug delivery market.Keywords: R³ UV exposure, optical model, UV dose, reflection, solvent concentration, biodegradable polymer microneedle
Procedia PDF Downloads 1677947 The Usage of Nitrogen Gas and Alum for Sludge Dewatering
Authors: Mamdouh Yousef Saleh, Medhat Hosny El-Zahar, Shymaa El-Dosoky
Abstract:
In most cases, the associated processing cost of dewatering sludge increase with the solid particles concentration. All experiments in this study were conducted on biological sludge type. All experiments help to reduce the greenhouse gases in addition, the technology used was faster in time and less in cost compared to other methods. First, the bubbling pressure was used to dissolve N₂ gas into the sludge, second alum was added to accelerate the process of coagulation of the sludge particles and facilitate their flotation, and third nitrogen gas was used to help floating the sludge particles and reduce the processing time because of the nitrogen gas from the inert gases. The conclusions of this experiment were as follows: first, the best conditions were obtained when the bubbling pressure was 0.6 bar. Second, the best alum dose was determined to help the sludge agglomerate and float. During the experiment, the best alum dose was 80 mg/L. It increased concentration of the sludge by 7-8 times. Third, the economic dose of nitrogen gas was 60 mg/L with separation efficiency of 85%. The sludge concentration was about 8-9 times. That happened due to the gas released tiny bubbles which adhere to the suspended matter causing them to float to the surface of the water where it could be then removed.Keywords: nitrogen gas, biological treatment, alum, dewatering sludge, greenhouse gases
Procedia PDF Downloads 2187946 Influence of Moringa Leaves Extract on the Response of Hb Molecule to Dose Rates’ Changes: II. Relaxation Time and Its Thermodynamic Driven State Functions
Authors: Mohamed M. M. Elnasharty, Azhar M. Elwan
Abstract:
Irradiation deposits energy through ionisation changing the bio-system’s net dipole, allowing the use of dielectric parameters and thermodynamic state functions related to these parameters as biophysical detectors to electrical inhomogeneity within the biosystem. This part is concerned with the effect of Moringa leaves extract, natural supplement, on the response of the biosystem to two different dose rates of irradiation. Having Hb molecule as a representative to the biosystem to be least invasive to the biosystem, dielectric measurements were used to extract the relaxation time of certain process found in the Hb spectrum within the indicated frequency window and the interrelated thermodynamic state functions were calculated from the deduced relaxation time. The results showed that relaxation time was decreased for both dose rates indicating a strong influence of Moringa on the response of biosystem and consequently Hb molecule. This influence was presented in the relaxation time and other parameters as well.Keywords: activation energy, DC conductivity, dielectric relaxation, enthalpy change, Moringa leaves extract, relaxation time
Procedia PDF Downloads 1487945 Synthesis and Thermoluminescence Investigations of Doped LiF Nanophosphor
Authors: Pooja Seth, Shruti Aggarwal
Abstract:
Thermoluminescence dosimetry (TLD) is one of the most effective methods for the assessment of dose during diagnostic radiology and radiotherapy applications. In these applications monitoring of absorbed dose is essential to prevent patient from undue exposure and to evaluate the risks that may arise due to exposure. LiF based thermoluminescence (TL) dosimeters are promising materials for the estimation, calibration and monitoring of dose due to their favourable dosimetric characteristics like tissue-equivalence, high sensitivity, energy independence and dose linearity. As the TL efficiency of a phosphor strongly depends on the preparation route, it is interesting to investigate the TL properties of LiF based phosphor in nanocrystalline form. LiF doped with magnesium (Mg), copper (Cu), sodium (Na) and silicon (Si) in nanocrystalline form has been prepared using chemical co-precipitation method. Cubical shape LiF nanostructures are formed. TL dosimetry properties have been investigated by exposing it to gamma rays. TL glow curve structure of nanocrystalline form consists of a single peak at 419 K as compared to the multiple peaks observed in microcrystalline form. A consistent glow curve structure with maximum TL intensity at annealing temperature of 573 K and linear dose response from 0.1 to 1000 Gy is observed which is advantageous for radiotherapy application. Good reusability, low fading (5 % over a month) and negligible residual signal (0.0019%) are observed. As per photoluminescence measurements, wide emission band at 360 nm - 550 nm is observed in an undoped LiF. However, an intense peak at 488 nm is observed in doped LiF nanophosphor. The phosphor also exhibits the intense optically stimulated luminescence. Nanocrystalline LiF: Mg, Cu, Na, Si phosphor prepared by co-precipitation method showed simple glow curve structure, linear dose response, reproducibility, negligible residual signal, good thermal stability and low fading. The LiF: Mg, Cu, Na, Si phosphor in nanocrystalline form has tremendous potential in diagnostic radiology, radiotherapy and high energy radiation application.Keywords: thermoluminescence, nanophosphor, optically stimulated luminescence, co-precipitation method
Procedia PDF Downloads 4057944 Anti-Anxiety Activity of Ethyl Acetate Extract of Flowers Nerium indicum
Authors: Deepak Suresh Mohale, Anil V. Chandewar
Abstract:
Anxiety is defined as an exaggerated feeling of apprehension, uncertainty and fear. Nerium indicum is a well-known ornamental and medicinal plant belonging to the family Apocynaceae. A wide spectrum of biological activities has been reported with various constituents isolated from different parts of the plant. This study was conducted to investigate antianxiety activity of flower extract. Flowers were collected and dried in shade and coarsely powdered. Powdered mixture was extracted with ethyl acetate by maceration process. Extract of flowers obtained was subsequently dried in oven at 40-50 °C. This extract is then tested for antianxiety activity at low and high dose using elevated plus maze and light & dark model. Rats shown increased open arm entries and time spent in open arm in elevated Plus maze with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. In Light & dark Model, light box entries and time spent in light box increased with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. From result it is concluded that ethyl acetate extract of flower of Nerium indicum possess antianxiety activity at low and high dose.Keywords: antianxiety, anxiety, kaner, nerium indicum, social isolation
Procedia PDF Downloads 3927943 Solar and Galactic Cosmic Ray Impacts on Ambient Dose Equivalent Considering a Flight Path Statistic Representative to World-Traffic
Abstract:
The earth is constantly bombarded by cosmic rays that can be of either galactic or solar origin. Thus, humans are exposed to high levels of galactic radiation due to altitude aircraft. The typical total ambient dose equivalent for a transatlantic flight is about 50 μSv during quiet solar activity. On the contrary, estimations differ by one order of magnitude for the contribution induced by certain solar particle events. Indeed, during Ground Level Enhancements (GLE) event, the Sun can emit particles of sufficient energy and intensity to raise radiation levels on Earth's surface. Analyses of GLE characteristics occurring since 1942 showed that for the worst of them, the dose level is of the order of 1 mSv and more. The largest of these events was observed on February 1956 for which the ambient dose equivalent rate is in the orders of 10 mSv/hr. The extra dose at aircraft altitudes for a flight during this event might have been about 20 mSv, i.e. comparable with the annual limit for aircrew. The most recent GLE, occurred on September 2017 resulting from an X-class solar flare, and it was measured on the surface of both the Earth and Mars using the Radiation Assessment Detector on the Mars Science Laboratory's Curiosity Rover. Recently, Hubert et al. proposed a GLE model included in a particle transport platform (named ATMORAD) describing the extensive air shower characteristics and allowing to assess the ambient dose equivalent. In this approach, the GCR is based on the Force-Field approximation model. The physical description of the Solar Cosmic Ray (i.e. SCR) considers the primary differential rigidity spectrum and the distribution of primary particles at the top of the atmosphere. ATMORAD allows to determine the spectral fluence rate of secondary particles induced by extensive showers, considering altitude range from ground to 45 km. Ambient dose equivalent can be determined using fluence-to-ambient dose equivalent conversion coefficients. The objective of this paper is to analyze the GCR and SCR impacts on ambient dose equivalent considering a high number statistic of world-flight paths. Flight trajectories are based on the Eurocontrol Demand Data Repository (DDR) and consider realistic flight plan with and without regulations or updated with Radar Data from CFMU (Central Flow Management Unit). The final paper will present exhaustive analyses implying solar impacts on ambient dose equivalent level and will propose detailed analyses considering route and airplane characteristics (departure, arrival, continent, airplane type etc.), and the phasing of the solar event. Preliminary results show an important impact of the flight path, particularly the latitude which drives the cutoff rigidity variations. Moreover, dose values vary drastically during GLE events, on the one hand with the route path (latitude, longitude altitude), on the other hand with the phasing of the solar event. Considering the GLE occurred on 23 February 1956, the average ambient dose equivalent evaluated for a flight Paris - New York is around 1.6 mSv, which is relevant to previous works This point highlights the importance of monitoring these solar events and of developing semi-empirical and particle transport method to obtain a reliable calculation of dose levels.Keywords: cosmic ray, human dose, solar flare, aviation
Procedia PDF Downloads 2067942 Evaluating the Dosimetric Performance for 3D Treatment Planning System for Wedged and Off-Axis Fields
Authors: Nashaat A. Deiab, Aida Radwan, Mohamed S. Yahiya, Mohamed Elnagdy, Rasha Moustafa
Abstract:
This study is to evaluate the dosimetric performance of our institution's 3D treatment planning system for wedged and off-axis 6MV photon beams, guided by the recommended QA tests documented in the AAPM TG53; NCS report 15 test packages, IAEA TRS 430 and ESTRO booklet no.7. The study was performed for Elekta Precise linear accelerator designed for clinical range of 4, 6 and 15 MV photon beams with asymmetric jaws and fully integrated multileaf collimator that enables high conformance to target with sharp field edges. Ten tests were applied on solid water equivalent phantom along with 2D array dose detection system. The calculated doses using 3D treatment planning system PrecisePLAN were compared with measured doses to make sure that the dose calculations are accurate for simple situations such as square and elongated fields, different SSD, beam modifiers e.g. wedges, blocks, MLC-shaped fields and asymmetric collimator settings. The QA results showed dosimetric accuracy of the TPS within the specified tolerance limits. Except for large elongated wedged field, the central axis and outside central axis have errors of 0.2% and 0.5%, respectively, and off- planned and off-axis elongated fields the region outside the central axis of the beam errors are 0.2% and 1.1%, respectively. The dosimetric investigated results yielded differences within the accepted tolerance level as recommended. Differences between dose values predicted by the TPS and measured values at the same point are the result from limitations of the dose calculation, uncertainties in the measurement procedure, or fluctuations in the output of the accelerator.Keywords: quality assurance, dose calculation, wedged fields, off-axis fields, 3D treatment planning system, photon beam
Procedia PDF Downloads 4467941 The Effect of Acute Toxicity and Thyroid Hormone Treatments on Hormonal Changes during Embryogenesis of Acipenser persicus
Authors: Samaneh Nazeri, Bagher Mojazi Amiri, Hamid Farahmand
Abstract:
Production of high quality fish eggs with reasonable hatching rate makes a success in aquaculture industries. It is influenced by the environmental stimulators and inhibitors. Diazinon is a widely-used pesticide in Golestan province (Southern Caspian Sea, North of Iran) which is washed to the aquatic environment (3 mg/L in the river). It is little known about the effect of this pesticide on the embryogenesis of sturgeon fish, the valuable species of the Caspian Sea. Hormonal content of the egg is an important factor to guaranty the successful passes of embryonic stages. In this study, the fate of Persian sturgeon embryo to 24, 48, 72, and 96-hours exposure of diazinon (LC50 dose) was tested. Also, the effect of thyroid hormones (T3 and T4) on these embryos was tested concurrently or separately with diazinon LC 50 dose. Fertilized eggs are exposed to T3 (low dose: 1 ng/ml, high dose: 10 ng/ml), T4 (low dose: 1 ng/ml, high dose: 10 ng/ml). Six eggs were randomly selected from each treatment (with three replicates) in five developmental stages (two cell- division, neural, heart present, heart beaten, and hatched larvae). The possibility of changing T3, T4, and cortisol contents of the embryos were determined in all treated groups and in every mentioned embryonic stage. The hatching rate in treated groups was assayed at the end of the embryogenesis to clarify the effect of thyroid hormones and diazinon. The results indicated significant differences in thyroid hormone contents, but no significant differences were recognized in cortisol levels at various early life stages of embryos. There was also significant difference in thyroid hormones in (T3, T4) + diazinon treated embryos (P˂0.05), while no significant difference between control and treatments in cortisol levels was observed. The highest hatching rate was recorded in HT3 treatment, while the lowest hatching rate was recorded for diazinon LC50 treatment. The result confirmed that Persian sturgeon embryo is less sensitive to diazinon compared to teleost embryos, and thyroid hormones may increase hatching rate even in the presence of diazinon.Keywords: Persian sturgeon, diazinon, thyroid hormones, cortisol, embryo
Procedia PDF Downloads 3047940 Analyzing the Effectiveness of Different Testing Techniques in Ensuring Software Quality
Authors: R. M. P. C. Bandara, M. L. L. Weerasinghe, K. T. C. R. Kumari, A. G. D. R. Hansika, D. I. De Silva, D. M. T. H. Dias
Abstract:
Software testing is an essential process in software development that aims to identify defects and ensure that software is functioning as intended. Various testing techniques are employed to achieve this goal, but the effectiveness of these techniques varies. This research paper analyzes the effectiveness of different testing techniques in ensuring software quality. The paper explores different testing techniques, including manual and automated testing, and evaluates their effectiveness in terms of identifying defects, reducing the number of defects in software, and ensuring that software meets its functional and non-functional requirements. Moreover, the paper will also investigate the impact of factors such as testing time, test coverage, and testing environment on the effectiveness of these techniques. This research aims to provide valuable insights into the effectiveness of different testing techniques, enabling software development teams to make informed decisions about the testing approach that is best suited to their needs. By improving testing techniques, the number of defects in software can be reduced, enhancing the quality of software and ultimately providing better software for users.Keywords: software testing life cycle, software testing techniques, software testing strategies, effectiveness, software quality
Procedia PDF Downloads 847939 Gold Nanoparticle: Synthesis, Characterization, Clinico-Pathological, Pathological and Bio-Distribution Studies in Rabbits
Authors: M. M. Bashandy, A. R. Ahmed, M. El-Gaffary, Sahar S. Abd El-Rahman
Abstract:
This study evaluated the acute toxicity and tissue distribution of intravenously administered gold nanoparticles (AuNPs) in male rabbits. Rabbits were exposed to single dose of AuNPs (300 µg/ kg). Toxic effects were assessed via general behavior, hematological parameters, serum biochemical parameters and histopathological examination of various rabbits’ organs. Tissue distribution of AuNPs was evaluated at a dose of 300 µg/ kg in male rabbit. Inductively coupled plasma–mass spectrometry (ICP-MS) was used to determine gold concentrations in tissue samples collected at predetermined time intervals. After one week, AuNPs exerted no obvious acute toxicity in rabbits. However, inflammatory reactions in lung and liver cells were induced in rabbits treated at the300 µg/ kg dose level. The highest gold levels were found in the spleen, followed by liver, lungs and kidneys. These results indicated that AuNPs could be distributed extensively to various tissues in the body, but primarily in the spleen and liver.Keywords: gold nanoparticles, toxicity, pathology, hematology, liver function, kidney function
Procedia PDF Downloads 3367938 Assessment of Gamma Radiation Exposure of Soils Associated with Granitic Rocks in Kapıdağ Peninsula, Turkey
Authors: Buket Canbaz Öztürk, N. Füsun Çam, Günseli Yaprak, Osman Candan
Abstract:
The external terrestrial radiation exposure is related to the types of rock from which the soils originate. Higher radiation levels are associated with igneous rocks, such as granite, and lower levels with sedimentary rocks. Therefore, this study aims to assess the gamma radiation exposure of soils associated with granitic rocks in Kapıdağ Peninsula, Turkey. In the ongoing study, a comprehensive survey carried out systematically as a part of the environmental monitoring program on radiologic impact of the granitoid areas in Western Anatolia. The activity measurements of the gamma emitters (238U, 232Th and 40K) in the surface soil samples and the granitic rocks carried out by means of NaI(Tl) gamma-ray spectrometry system. To evaluate the radiological hazard of the natural radioactivity, the absorbed dose rate (D), the annual effective dose rate (AED), the radium equivalent activity (Raeq) and the external (Hex) hazard index were calculated according to the UNSCEAR 2000 report. The corresponding absorbed dose rates in air from all natural radionuclides were always much lower than 200 nGy h-1 and did not exceed the typical range of worldwide average values noticed in the UNSCEAR (2000) report. Furthermore, the correlation between soil and granitic rock samples were utilized, and external gamma radiation exposure distribution was mapped in Kapıdağ Peninsula.Keywords: external absorbed dose, granitic rocks, Kapıdağ Peninsula, soil
Procedia PDF Downloads 2367937 Intrathecal Sufentanil or Fentanyl as Adjuvants to Low Dose Bupivacaine in Endoscopic Urological Procedures
Authors: Shikha Gupta, Suneet Kathuria, Supriya Sampley, Sunil Katyal
Abstract:
Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.Keywords: adjuvants, bupivacaine, fentanyl, intrathecal, low dose spinal, sufentanil
Procedia PDF Downloads 3767936 A Review of Soil Stabilization Techniques
Authors: Amin Chegenizadeh, Mahdi Keramatikerman
Abstract:
Soil stabilization is a crucial issue that helps to remove of risks associated with the soil failure. As soil has applications in different industries such as construction, pavement and railways, the means of stabilizing soil are varied. This paper will focus on the techniques of stabilizing soils. It will do so by gathering useful information on the state of the art in the field of soil stabilization, investigating both traditional and advanced methods. To inquire into the current knowledge, the existing literature will be divided into categories addressing the different techniques.Keywords: review, soil, stabilization, techniques
Procedia PDF Downloads 5457935 Interaction between NiCl2 and Selenium on Energy Profiles in Wistar albino Preimplanted Rats
Authors: O. Adjroud
Abstract:
The present study was conducted to investigate the interaction between selenium (Se) and chloride nickel (NiCl2) on energy profiles in Wistar albino preimplanted rats. NiCl2 was given on day 3 of pregnancy either in distilled drinking water at a dose of 20 mg/L/day for 16 consecutive days or as a single subcutaneous (s.c.) dose of 25, 50, or 100 mg/kg. Se was given as a s.c. injection (0.3 mg/kg) together with the higher dose (100 mg/kg) of NiCl2. Changes in energy profiles were evaluated in treated and control groups on days 5 and 20 of gestation. NiCl2 s.c. induced a significant increase in plasma glucose on day 20 of pregnancy. NiCl2 s.c. induced on day 5 and 20 of gestation a significant decrease in plasma triglycerides, with the higher dose. This decrease was maintained at day 20 of gestation with doses of 50 mg /kg. In addition, NiCl2 s.c. caused on day 5 of gestation a significant decrease in plasma total cholesterol with the low and medium doses. The pretreatment with Se reversed the effects of NiCl2 on plasma glucose, total cholesterol and triglycerides levels. NiCl2 administered in the drinking water augmented significantly the plasma triglycerides and total cholesterol levels and slighty the plasma glucose on day 20 of gestation, while on day 5 of gestation NiCl2 s.c. Induced a significant decrease in cholesterol. Three doses of NiCl2 (sc) induced severe alterations in liver and architecture which are markedly improved by Selenium. These results suggested that selenium has protective effects on energy profiles against the toxicity induced by NiCl2 administered subcutaneously in preimplanted rats.Keywords: hepatotoxicity, nickel chloride, preimplanted rat, biochemical parameters
Procedia PDF Downloads 4097934 12-Week Comparative Clinical Trial with Low Dose Phentermine/Topiramate with Liraglutide on Obesity in Korea
Authors: Kyu Rae Lee
Abstract:
The aim of the study is to investigate the clinical efficacy of combination therapeutic modalities using liraglutide (1.2mg/d) add on low-dose phentermine (7.5 mg/d)/topiramate (50mg/d) medication on the obese patient in the bariatric clinic. We assessed the retrospective cohort clinical analyses to the clinical efficacy of medication and combination in the patients who visited the bariatric clinic. We measured all participants’ body fat (bioelectric impedance analysis), weight, height, and the cross-sectional areas of adipose tissues (umbilicus level) after keep fasting for 8 hours at 0, 4, 12 weeks. The design of the study was opened, paired t-test and Wilcoxon test were performed using SPSS for windows (ver.18, IL, USA) for comparison of weight, body fat, and adipose tissues. The participants were one hundred twenty-eight subjects aged 44.67 (1.18) years, 28.95 (0.39) kg/m², and female (82.7%). Their body fat was 40.57 (2.23%), and waist to hip ratio was 0.96 (0.01). The mean cross-sectional area of visceral adipose tissue was 142.59 (7.06) mm², and that of subcutaneous adipose was 274.37 (9.18) mm². 73 of them (57.5%) took medication only, 54 of them took medication with liraglutide for 12 weeks. The subjects in the medication group lost 5.4165 kg, 6.8069%, and those of the combination group did 6.2481 kg, 3.564%. The mean cross-sectional areas of visceral, subcutaneous adipose tissue in the medication group significantly decreased (p=.043), even more in the combination group. (p=.028). Further controlled clinical trials should be considered in the future. We conclude that the low dose of phentermine/topiramate with liraglutide therapeutic modalities would be more effective than phentermine/topiramate medication only in obesity treatment for 12 weeks.Keywords: low dose phentermine, topiramate, liraglutide, obesity, efficacy
Procedia PDF Downloads 1587933 Removal of Vanadium from Industrial Effluents by Natural Ion Exchanger
Authors: Shashikant R. Kuchekar, Haribhau R. Aher, Priti M. Dhage
Abstract:
The removal vanadium from aqueous solution using natural exchanger was investigated. The effects of pH, contact time and exchanger dose were studied at ambient temperature (25 0C ± 2 0C). The equilibrium process was described by the Langmuir isotherm model with adsorption capacity for vanadium. The natural exchanger i.e. tamarindus seeds powder was treated with formaldehyde and sulpuric acid to increase the adsorptivity of metals. The maximum exchange level was attained as 80.1% at pH 3 with exchanger dose 5 g and contact time 60 min. Method is applied for removal of vanadium from industrial effluents.Keywords: industrial effluent, natural ion exchange, Tamarindous indica, vanadium
Procedia PDF Downloads 2517932 Induction of Labor Using Misoprostol with or without Mifepristone in Intrauterine Death: A Randomized Controlled Study
Authors: Ajay Agrawal, Pritha Basnet, Achala Thakur, Pappu Rizal, Rubina Rai
Abstract:
Context: Rapid expulsion of fetus in intrauterine fetal death (IUFD) is usually requested without any medical grounds for it. So; an efficient, safe method for induction of labor (IOL) is required. Objective: To determine if pre-treatment with mifepristone followed by IOL with misoprostol in late IUFD is more efficacious. Methods: We conducted a randomized controlled trial in 100 patients. Group-A women received single oral dose of 200 mg mifepristone, followed by induction with vaginal misoprostol after 24-hour. Group-B women were induced only with vaginal misoprostol. In each group 5 dose of misoprostol was used 4 hourly. If first cycle was unsuccessful, after break of 12 hour, second course of misoprostol was started. The primary outcome was a measure of induction to delivery time and vaginal delivery within 24 hours. Secondary outcome was to measure need of oxytocin and complications. Results: Maternal age, parity and period of gestation were comparable between groups. Number of misoprostol dose needed in group A was significantly less than group B. Mann Whitney U test showed, women in group A had significantly earlier onset of labor, however total induction to delivery interval was not significant. In group-A, 85.7% delivered within 24 hours of first dose of misoprostol while in group-B 70% delivered within 24 hour (p=0.07). More women in Group B required oxytocin. Conclusion: Pretreatment with mifepristone before IOL following late IUFD is an effective and safe regimen. It appears to shorten the duration of induction to onset of labor.Keywords: induction of labor, intrauterine fetal death, mifepristone, misoprostol
Procedia PDF Downloads 377