Search results for: rabies treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8270

Search results for: rabies treatment

6410 The Effectiveness of Zinc Supplementation in Taste Disorder Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Boshra Mozaffar, Arash Ardavani, Iskandar Idris

Abstract:

Food taste and flavor affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect taste which can result in reduced appetite, weight loss and psychological problems, but the efficacy of Zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. We searched four electronic bibliographical databases; Ovid MEDLINE, Ovid Embase, Ovid AMAD and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. To facilitate the collection and identification of all available and relevant articles published before 7 December 2020, there were no restrictions on the publication date. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. In total, we included 12 randomized controlled trials with 938 subjects. Intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc and acetate); the pooled results of the meta-analysis indicate that improvements in taste disorder occurred more frequently in the intervention group compared to the control group (RR = 1.8; 95% CI:1.27 -2.57, p=0.009). The doses are equivalent to 17 mg- 86.7 mg of elemental zin for three to six months. Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency or idiopathic taste disorders when given in high doses ranging from 68–86.7 mg/d for up to three months. However, we did not find sufficient evidence to determine the effectiveness of zinc supplementation in patients with taste disorders induced by chronic renal failure.

Keywords: taste change, taste disorder, zinc, zinc sulfate or Zn, deficiency, supplementation.

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6409 Effect of Manure Treatment on Furrow Erosion: A Case Study of Sagawika Irrigation Scheme in Kasungu, Malawi

Authors: Abel Mahowe

Abstract:

Furrow erosion is the major problem menacing sustainability of irrigation in Malawi and polluting water bodies resulting in death of many aquatic animals. Many rivers in Malawi are drying due to some poor practices that are being practiced around these water bodies, furrow erosion is one of the cause of sedimentation in these rivers although it has gradual effect on deteriorating of these rivers hence neglected, but has got long term disastrous effect on water bodies. Many aquatic animals also suffer when these sediments are taken into these water bodies. An assessment of effect of manure treatment on furrow erosion was carried out in Sagawika irrigation scheme located in Kasungu District north part of Malawi. The soil on the field was clay loam and had just been tilled. The average furrow slope of 0.2% and was divided into two blocks, A and B. Each block had 20V-shaped furrow having a length of 10 m. Three different manure were used to construct these furrows by mixing it with soil which was moderately moist and 5 furrows from each block were constructed without manure. In each block 5furrow were made using a specific type of manure, and one set of five furrows in each block was made without manure treatment. The types of manure that were used were goat manure, pig manure, and manure from crop residuals. The manure application late was 5 kg/m. The furrow was constructed at a spacing of 0.6 m. Tomato was planted in the two blocks at spacing of 0.15 m between rows and 0.15 m between planting stations. Irrigation water was led from feeder canal into the irrigation furrows using siphons. The siphons discharge into each furrow was set at 1.86 L/S. The ¾ rule was used to determine the cut-off time for the irrigation cycles in order to reduce the run-off at the tail end. During each irrigation cycle, samples of the runoff water were collected at one-minute intervals and analyzed for total sediment concentration for use in estimating the total soil sediment loss. The results of the study have shown that a significant amount of soil is lost in soils without many organic matters, there was a low level of erosion in furrows that were constructed using manure treatment within the blocks. In addition, the results have shown that manure also differs in their ability to control erosion since pig manure proved to have greater abilities in binding the soil together than other manure since they were reduction in the amount of sediments at the tail end of furrows constructed by this type of manure. The results prove that manure contains organic matters which helps soil particles to bind together hence resisting the erosive force of water. The use of manure when constructing furrows in soil with less organic matter can highly reduce erosion hence reducing also pollution of water bodies and improve the conditions of aquatic animals.

Keywords: aquatic, erosion, furrow, soil

Procedia PDF Downloads 287
6408 Implication of Oxidative Stress and Intracellular Mediators in the Protective Effect of Artemisia campestris against Aspirin-Induced Gastric Lesions in Rat Model

Authors: Hichem Sebai, Mohamed Amine Jabri, Kais Rtibi, Haifa Tounsi, Lamjed Marzouki

Abstract:

Artemisia campestris has been widely used in Tunisian traditional medicine for its health beneficial effects. However, the present study aims at evaluating the antiulcer effects of Artemisia campestris aqueous extract (ACAE) as well as the mechanism of action involved in such gastroprotection. In this respect, male Wistar rats were divided into seven groups: control, aspirin (ASPR), ASPR + various doses of ACAE (100, 200 and 400 mg/kg, b.w.), ASPR+ famotidine and ASPR+ caffeic acid. Animals were pre-treated with ACAE extract during 10 days. We firstly showed that aspirin administration was accompanied by an oxidative stress status assessed by an increase of malondialdehyde (MDA) level, a decrease of sulfhydryl -(SH) groups content and depletion of antioxidant enzyme activities such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Pre-treatment with ACAE protected against aspirin-induced gastric oxidative stress. More importantly, aspirin administration increased plasma and tissue hydrogen peroxide (H₂O₂), free iron and calcium levels while the ACAE pre-treatment reversed all aspirin-induced intracellular mediators disturbance. The results of the present study clearly indicated that AEAC gastroprotection might be related, at least in part, to its antioxidant properties as well as to various gastric mucosal defense mechanisms, including the protection of gastric sulfhydryls and an opposite effect on some intracellular mediators such as free iron, hydrogen peroxide, and calcium. However, our data confirm the use of Artemisia campestris extracts in the Tunisian traditional folk medicine for the treatment of gastrointestinal diseases.

Keywords: gastric ulcer, Artemisia campestris, oxidative stress, sulfhydryl groups, Fenton reaction, rat

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6407 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017

Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

Abstract:

Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

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6406 The Response of Soil Biodiversity to Agriculture Practice in Rhizosphere

Authors: Yan Wang, Guowei Chen, Gang Wang

Abstract:

Soil microbial diversity is one of the important parameters to assess the soil fertility and soil health, even stability of the ecosystem. In this paper, we aim to reveal the soil microbial difference in rhizosphere and root zone, even to pick the special biomarkers influenced by the long term tillage practices, which included four treatments of no-tillage, ridge tillage, continuous cropping with corn and crop rotation with corn and soybean. Here, high-throughput sequencing was performed to investigate the difference of bacteria in rhizosphere and root zone. The results showed a very significant difference of species richness between rhizosphere and root zone soil at the same crop rotation system (p < 0.01), and also significant difference of species richness was found between continuous cropping with corn and corn-soybean rotation treatment in the rhizosphere statement, no-tillage and ridge tillage in root zone soils. Implied by further beta diversity analysis, both tillage methods and crop rotation systems influence the soil microbial diversity and community structure in varying degree. The composition and community structure of microbes in rhizosphere and root zone soils were clustered distinctly by the beta diversity (p < 0.05). Linear discriminant analysis coupled with effect size (LEfSe) analysis of total taxa in rhizosphere picked more than 100 bacterial taxa, which were significantly more abundant than that in root zone soils, whereas the number of biomarkers was lower between the continuous cropping with corn and crop rotation treatment, the same pattern was found at no-tillage and ridge tillage treatment. Bacterial communities were greatly influenced by main environmental factors in large scale, which is the result of biological adaptation and acclimation, hence it is beneficial for optimizing agricultural practices.

Keywords: tillage methods, biomarker, biodiversity, rhizosphere

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6405 The Adsorption of Perfluorooctanoic Acid on Coconut Shell Activated Carbons

Authors: Premrudee Kanchanapiya, Supachai Songngam, Thanapol Tantisattayakul

Abstract:

Perfluorooctanoic acid (PFOA) is one of per- and polyfluoroalkyl substances (PFAS) that have increasingly attracted concerns due to their global distribution in environment, persistence, high bioaccumulation, and toxicity. It is important to study the effective treatment to remove PFOA from contaminated water. The feasibility of using commercial coconut shell activated carbon produced in Thailand to remove PFOA from water was investigated with regard to their adsorption kinetics and isotherms of powder activated carbon (PAC-325) and granular activated carbon (GAC-20x50). Adsorption kinetic results show that the adsorbent size significantly affected the adsorption rate of PFOA, and GAC-20x50 required at least 100 h to achieve the equilibrium, much longer than 3 h for PAC-325. Two kinetic models were fitted to the experimental data, and the pseudo-second-order model well described the adsorption of PFOA on both PAC-325 and GAC-20x50. PAC-325 trended to adsorb PFOA faster than GAC-20x50, and testing with the shortest adsorption times (5 min) still yielded substantial PFOA removal (~80% for PAC-325). The adsorption isotherms show that the adsorption capacity of PAC-325 was 0.80 mmol/g, which is 83 % higher than that for GAC-20x50 (0.13 mmol/g), according to the Langmuir fitting.

Keywords: perfluorooctanoic acid, PFOA, coconut shell activated carbons, adsorption, water treatment

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6404 The Antioxidant and Antinociceptive Effects of Curcumin in Experimentally Induced Pain in Rats

Authors: Valeriu Mihai But, Sorana Daniela Bolboacă, Adriana Elena Bulboacă

Abstract:

The nutraceutical compound Curcumin (Curcuma longa L.) is known for its anti-inflammatory, anti-cancer, and antioxidant effects. This study aimed to evaluate the antioxidative and analgesic effects of Curcumin (CC) compared to Tramadol (T) in chemical-induced nociceptive pain in rats. Thirty-five rats were randomly divided into five groups of seven rats each and were treated as follows: C group (control group): treated with saline solution 0.9%, (1 ml, i.p. administration), ethanoic acid (EA) group: pretreated with saline solution 0.9% - 30 min before EA nociceptive pain induction, (1 ml, i.p. administration), T group: pretreated with Tramadol, 10 mg/kg body weight (bw), i.p. administration - 30 min before EA nociceptive pain induction, CC1-group: pretreated with 1 mg/100g bw Curcumin i.p. administration - 2 days before EA pain induction and CC2-group: pretreated with Curcumin 2 mg/100g bw i.p. administration - 2 days before EA nociceptive pain induction. The following oxidative stress parameters were assessed: malondialdehyde (MDA), nitric oxide (NOx), total oxidative status (TOS), total antioxidative capacity (TAC), and thiol (Th). The antalgic activity was measured by the ethanoic acid writhing test. Treatment with Curcumin, both 1 mg/100g bw, and 2 mg/100g bw, showed significant differences as compared with the control group (p<0.001) regarding malondialdehyde (MDA), nitric oxide (NOx), and total oxidative status (TOS) oxidative biomarkers. Pretreatment with 2 mg/100g bw of Curcumin presented a significant decrease in MDA values compared with Tramadol (p<0.001). The TAC significantly increased in pretreatment with Curcumin compared with group control. (p<0.001) The nociceptive response to EA was significantly reduced in Curcumin and Tramadol groups. Treatment with Curcumin at a higher concentration was more effective. In an experimental pain model, this study demonstrates an important antioxidant and antinociceptive activity of Curcumin comparable with Tramadol treatment.

Keywords: curcumin, nociception, oxidative stress, pain

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6403 Post-Operative Pain Management in Ehlers-Danlos Hypermobile-Type Syndrome Following Wisdom Teeth Extraction: A Case Report and Literature Review

Authors: Aikaterini Amanatidou

Abstract:

We describe the case of a 20-year-old female patient diagnosed with Ehlers-Danlos Syndrome (EDS) who was scheduled to undergo a wisdom teeth extraction in outpatient surgery. EDS is a hereditary connective tissue disorder characterized by joint hypermobility, skin hyper-extensibility, and vascular and soft tissue fragility. There are six subtypes of Ehlers-Danlos, and in our case, the patient had EDS hyper-mobility (HT) type disorder. One important clinical feature of this syndrome is chronic pain, which is often poorly understood and treated. Our patient had a long history of articular and lumbar pain when she was diagnosed. She was prescribed analgesic treatment for acute and neuropathic pain and had multiple sessions of psychotherapy and physiotherapy to ease the pain. Unfortunately, her extensive medical history was underrated by our anesthetic team, and no further measures were taken for the operation. Despite an uneventful intra-operative phase, the patient experienced several episodes of hyperalgesia during the immediate post-operative care. Management of pain was challenging for the anesthetic team: initial opioid treatment had only a temporary effect and a paradoxical reaction after a while. Final pain relief was eventually obtained with psycho-physiologic treatment, high doses of ketamine, and patient-controlled analgesia infusion of morphine-ketamine-dehydrobenzperidol. We suspected an episode of Opioid-Induced hyperalgesia. This case report supports the hypothesis that anti-hyperalgesics such as ketamine as well as lidocaine, and dexmedetomidine should be considered intra-operatively to avoid opioid-induced hyperalgesia and may be an alternative solution to manage complex chronic pain like others in neuropathic pain syndromes.

Keywords: Ehlers-Danlos, post-operative management, hyperalgesia, opioid-induced hyperalgesia, rare disease

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6402 Nursing Experience for a Lung Cancer Patient Undergoing First Time Concurrent Chemotherapy and Radiation Therapy

Authors: Hui Ling Chen

Abstract:

This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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6401 Evaluation of Trabectedin Safety and Effectiveness at a Tertiary Cancer Center at Qatar: A Retrospective Analysis

Authors: Nabil Omar, Farah Jibril, Oraib Amjad

Abstract:

Purpose: Trabecatine is a is a potent marine-derived antineoplastic drug which binds to the minor groove of the DNA, bending DNA towards the major groove resulting in a changed conformation that interferes with several DNA transcription factors, repair pathways and cell proliferation. Trabectedin was approved by the European Medicines Agency (EMA; London, UK) for the treatment of adult patients with advanced stage soft tissue sarcomas in whom treatment with anthracyclines and ifosfamide has failed, or for those who are not candidates for these therapies. The recommended dosing regimen is 1.5 mg/m2 IV over 24 hours every 3 weeks. The purpose of this study was to comprehensively review available data on the safety and efficacy of trabectedin used as indicated for patients at a Tertiary Cancer Center at Qatar. Methods: A medication administration report generated in the electronic health record identified all patients who received trabectedin between November 1, 2015 and November 1, 2017. This retrospective chart review evaluated the indication of trabectedin use, compliance to administration protocol and the recommended monitoring parameters, number of patients improved on the drug and continued treatment, number of patients discontinued treatment due to side-effects and the reported side effects. Progress and discharged notes were utilized to report experienced side effects during trabectedin therapy. A total of 3 patients were reviewed. Results: Total of 2 out of 3 patients who received trabectedin were receiving it for non-FDA and non-EMA, approved indications; metastatic rhabdomyosarcoma and ovarian cancer stage IV with poor prognosis. And only one patient received it as indicated for leiomyosarcoma of left ureter with metastases to liver, lungs and bone. None of the patients has continued the therapy due to development of serious side effects. One patient had stopped the medication after one cycle due to disease progression and transient hepatic toxicity, the other one had disease progression and developed 12 % reduction in LVEF after 12 cycles of trabectedin, and the third patient deceased, had disease progression on trabectedin after the 10th cycle that was received through peripheral line which resulted in developing extravasation and left arm cellulitis requiring debridement. Regarding monitoring parameters, at baseline the three patients had ECHO, and Creatine Phosphokinase (CPK) but it was not monitored during treatment as recommended. Conclusion: Utilizing this medication as indicated with performing the appropriate monitoring parameters as recommended can benefit patients who are receiving it. It is important to reinforce the intravenous administration via central intravenous line, the re-assessment of left ventricular ejection fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan at 2- to 3-month intervals thereafter until therapy is discontinued, and CPK and LFTs levels prior to each administration of trabectedin.

Keywords: trabectedin, drug-use evaluation, safety, effectiveness, adverse drug reaction, monitoring

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6400 Virtual Reality in COVID-19 Stroke Rehabilitation: Preliminary Outcomes

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

Abstract:

Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of Covid-19 infection. Understanding novel treatment approaches are important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with virtual reality (VR) included. This game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with covid-19 related CVA. The safety of newly developed instruments for such cases provides new approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: covid-19, stroke, virtual reality, rehabilitation

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6399 Smart Brain Wave Sensor for Paralyzed- a Real Time Implementation

Authors: U.B Mahadevswamy UBM, Siraj Ahmed Siraj

Abstract:

As the title of the paper indicates about brainwaves and its uses for various applications based on their frequencies and different parameters which can be implemented as real time application with the title a smart brain wave sensor system for paralyzed patients. Brain wave sensing is to detect a person's mental status. The purpose of brain wave sensing is to give exact treatment to paralyzed patients. The data or signal is obtained from the brainwaves sensing band. This data are converted as object files using Visual Basics. The processed data is further sent to Arduino which has the human's behavioral aspects like emotions, sensations, feelings, and desires. The proposed device can sense human brainwaves and detect the percentage of paralysis that the person is suffering. The advantage of this paper is to give a real-time smart sensor device for paralyzed patients with paralysis percentage for their exact treatment. Keywords:-Brainwave sensor, BMI, Brain scan, EEG, MCH.

Keywords: Keywords:-Brainwave sensor , BMI, Brain scan, EEG, MCH

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6398 Availability of Metals in Fired Bricks Incorporating Harbour Sediments

Authors: Fabienne Baraud, Lydia Leleyter, Sandra Poree, Melanie Lemoine, Fatiha Oudghiri

Abstract:

Alternative solutions to immersion at sea are searched for the huge amounts of dredged sediments around the world that might contain various types of contaminants. Possible re-uses of such materials in civil engineering appear as sustainable solutions. The French SEDIBRIC project (valorisation de SEDIments en BRIQues et tuiles) aims to replace a part of natural clays with dredged sediments in the preparation of fired bricks. The potential environmental impact of this re-use is explored to complete the technical and economic feasibility of the study. As part of the project, we investigate the environmental availability of metallic elements (Al, Ca, Cd, Co, Cr, Cu, Fe, Ni, Mg, Mn, Pb, Ti, and Zn) initially present in the dredged sediments selected for the project. Leaching tests (with H₂O, HCl, or EDTA) are conducted in the sediments than in the final bricks in order to evaluate the possible influence of some steps of the bricks manufacturing (desalination pre-treatment, firing, etc.). The desalination pre-treatment using tap water has no or few impacts on the environmental availability of the studied elements. On the opposite, the firing process (900°C) affects the value of the total content of elements detected in the bricks but also the environmental availability for various elements. For instance, Cd, Cu, Pb, and Zn are stabilized in the bricks, whereas the availability of some other elements (i.e., Cr, Ni) increases, depending on the nature of the extracting solution.

Keywords: availability, bricks, dredged sediments, metals

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6397 The Effect of Blue Lighting on Feeding Behaviour, Growth, and Corticosterone of Broiler Chickens

Authors: Sri Harimurti, Diah Reni Asih

Abstract:

This study was designated to investigate the effect of intermittent and continuous blue lighting on the feeding behaviour, growth and corticosterone hormone concentration of broiler. Two thousands and seven hundreds unsexed day-old broiler were divided into three groups of lighting treatment. Each treatment consisted of three replicates of 300 birds. The treatments were ordinary lighting (C), intermittent blue lighting (IBL) and continuous blue lighting (CBL). The data were collected in the study were feeding behaviour such as feeding duration and frequency of feeding, growth rate of birds and corticosterone hormone concentration. Results showed that the CBL have significant effect (P<0,05) on duration and frequency of feeding and growth rate of birds. The CBL have the highest feeding duration, the lowest frequency of feeding that those 290.33±1.52 minutes/day, 35.58±0.50 times/day at 15 to 28 days of age.The concentration of corticosterone hormone of IBL and CBL were a significant (P<0.05) decrease. The conclusion of this study indicated that continuous blue lighting may be a good tool for improving welfare management of broiler.

Keywords: blue light, broiler chickens, corticosterone hormone, feeding behaviour, growth rate

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6396 The Impact of E-Learning on Medication Administration of Nursing Students

Authors: Z. Karakus, Z. Ozer

Abstract:

Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement, or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery, and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: e-learning, medication administration, nursing, nursing students

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6395 Phenol Removal from Water in the Presence of Nano-TiO₂ and a Natural Activated Carbon: Intensive and Extensive Processes

Authors: Hanane Belayachi, Fadila Nemchi, Amel Belayachi, Sarra Bourahla, Mostefa Belhakem

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In this work, two photocatalytic processes for the degradation of phenol in water are presented. The first one is extensive (EP), which is carried out in a treatment chain of two steps, allowing the adsorption of the pollutant by a naturally activated carbon from the grapes. This operation is followed by a photocatalytic degradation of the residual phenol in the presence of TiO₂. The second process is intensive (IP) and is realized in one step in the presence of a hybrid photocatalytic nanomaterial prepared from naturally activated carbon and TiO₂. The evaluation of the two processes, EP and IP, is based on the analytical monitoring of the initial and final parameters of the water to be treated, i.e., the phenol concentration by liquid phase chromatography (HPLC) and total organic carbon (TOC). For both processes, the sampling was carried out every 10 min for 120 min of treatment time to measure the phenol concentrations. The elimination and degradation rates in the case of the intensive process are better than the extensive process. In both processes, the catechol molecule was detected as an under product of degradation. In the IP case, this intermediate phenol was totally eliminated, and only traces of catechol persisted in the water.

Keywords: photocatalysis, hybrid, activated carbon, phenol

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6394 The Impact of Oxytetracycline on the Aquaponic System, Biofilter, and Plants

Authors: Hassan Alhoujeiri, Angele Matrat, Sandra Beaufort, Claire joaniss Cassan, Jerome Silvester

Abstract:

Aquaponics is a sustainable food production technology, and its transition to industrial-scale systems has created several challenges that require further investigation in order to make it a robust process. One of the critical concerns is the potential accumulation of compounds from veterinary treatments, phytosanitary agents, fish feed, or simply from contaminated water sources. The accumulation of these substances could negatively impact fish health, microbial biofilters, and plant growth, thereby disrupting the system’s overall balance and functionality. The lack of legislation and knowledge regarding the presence of such compounds in aquaponic systems raises concerns about their potential impact on both system balance and food safety. In this study, we focused on the effects of oxytetracycline (OTC), an antibiotic commonly used in aquaculture, on both the microbial biofilter and plant growth. Although OTC is rarely applied in aquaponics today, the fish compartment may need to be isolated from the system during treatment, as it inhibits specific bacterial populations, which could affect the microbial biofilter's efficiency. However, questions remain about the aquaponic system's tolerance threshold, particularly in cases of treatment or residual OTC traces post-treatment. This study results indicated a decline in microbial biofilter activity to 20% compared to the control, potentially corresponding to treatments of 41 mg/L of OTC. Analysis of microbial populations in the biofilter, using flow cytometry and microscopy (confocal and scanning electron microscopy), revealed an increase in bacterial mortality without disrupting the microbial biofilm. Additionally, OTC exposure led to noticeable changes in plant morphology (e.g., color) and growth, though it did not fully inhibit development. However, no significant effects were observed on seed germination at the tested concentrations despite a measurable impact on subsequent plant growth.

Keywords: aquaponic, oxytetracycline, nitrifying biofilter, plant, micropollutants, sustainability

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6393 Synergistic Cytotoxicity of Cisplatin and Taxol in Overcoming Taxol Resistance through the Inhibition of LDHA in Oral Squamous Cell Carcinoma

Authors: Lin Feng, Ling-Ling E., Hong-Chen Liu

Abstract:

The development of chemoresistance in patients represents a major challenge in cancer treatment. Lactate dehydrogenase‑A (LDHA) is one of the principle isoforms of LDH that is expressed in breast tissue, controlling the conversion of pyruvate to lactate and also playing a significant role in the metabolism of glucose. The aim of this study was to identify whether LDHA was involved in oral cancer cell resistance to Taxol and whether the downregulation of LDHA, as a result of cisplatin treatment, may overcome Taxol resistance in human oral squamous cells. The OECM‑1 oral epidermal carcinoma cell line was used, which has been widely used as a model of oral cancer in previous studies. The role of LDHA in Taxol and cisplatin resistance was investigated and the synergistic cytotoxicity of cisplatin and/or Taxol in oral squamous cells was analyzed. Cell viability was analyzed by MTT assay, LDHA expression was analyzed by western blot analysis and siRNA transfection was performed to knock down LDHA expression. The present study results showed that decreased levels of LDHA were responsible for the resistance of oral cancer cells to cisplatin (CDDP). CDDP treatments downregulated LDHA expression and lower levels of LDHA were detected in the CDDP‑resistant oral cancer cells compared with the CDDP‑sensitive cells. By contrast, the Taxol‑resistant cancer cells showed elevated LDHA expression levels. In addition, small interfering RNA‑knockdown of LDHA sensitized the cells to Taxol but desensitized them to CDDP treatment while exogenous expression of LDHA sensitized the cells to CDDP, but desensitized them to Taxol. The present study also revealed the synergistic cytotoxicity of CDDP and Taxol for killing oral cancer cells through the inhibition of LDHA. This study highlights LDHA as a novel therapeutic target for overcoming Taxol resistance in oral cancer patients using the combined treatments of Taxol and CDDP.

Keywords: cisplatin, Taxol, carcinoma, oral squamous cells

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6392 Anti-Scale Magnetic Method as a Prevention Method for Calcium Carbonate Scaling

Authors: Maha Salman, Gada Al-Nuwaibit

Abstract:

The effect of anti-scale magnetic method (AMM) in retarding scaling deposition is confirmed by many researchers, to result in new crystal morphology, the crystal which has the tendency to remain suspended more than precipitated. AMM is considered as an economic method when compared to other common methods used for scale prevention in desalination plant as acid treatment and addition of antiscalant. The current project was initiated to evaluate the effectiveness of AMM in preventing calcium carbonate scaling. The AMM was tested at different flow velocities (1.0, 0.5, 0.3, 0.1, and 0.003 m/s), different operating temperatures (50, 70, and 90°C), different feed pH and different magnetic field strength. The results showed that AMM was effective in retarding calcium carbonate scaling deposition, and the performance of AMM depends strongly on the flow velocity. The scaling retention time was found to be affected by the operating temperatures, flow velocity, and magnetic strength (MS), and in general, it was found that as the operating temperatures increased the effectiveness of the AMM in retarding calcium carbonate (CaCO₃) scaling increased.

Keywords: magnetic treatment, field strength, flow velocity, magnetic scale retention time

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6391 Investigation of the Effect of Eye Exercises and Convergence Exercise on Visual Acuity in School-Age Children with Hypermetropia

Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

Abstract:

Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

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6390 Assessment of Lipid Lowering Effect of Shilajit in Adult Male Rats

Authors: U. P. Rathnakar, Sejpal Jaykumar, Shenoy K. Ashok

Abstract:

The effect of Shilajit was investigated for lipid lowering activity and its effect on weight gain in Wistar albino rats. Shilajit, semi-hard brownish black resin formed through long-term humidification of several plant types, mainly bryophytes, can be obtained from steep rocks of the Himalayas at altitudes between 1000 to 5000 meters. Hyperlipidemia was produced by feeding the rats with the cholesterol-rich high-fat diet (HFD) for 2 months. This diet contained deoxycholic acid, cholesterol and warm coconut oil in powdered rat chow diet. At the end of study, Shilajit treated rats showed significant decrease in serum LDL, triglyceride and total cholesterol level as well as increase in serum HDL level, in comparison to rats fed on high-fat diet with no treatment. Also during study period, increase in weight in Shilajit treated group was significantly less than in the other group of rats fed on high-fat diet with no treatment. Thus, Shilajit has significantly controlled the development of hyperlipidemia and weight gain in high-fat diet fed rats in the present study.

Keywords: Shilajit, hyperlipidemia, weight control, cholesterol-rich high-fat diet

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6389 Standardization of Propagation Techniques for Celastrus paniculata: An Endangered Medicinal Plant of Western Ghats

Authors: Raviraja Shetty G., K. G. Poojitha

Abstract:

An experiment was conducted at College of Horticulture, Mudigere to study the effect of different growth regulators on seed germination and vegetative propagation by cuttings of Celastrus paniculata an endangered medicinal plant. The extracted seeds are subjected to 11 different pre-soaking treatments which include control, GA3 at 300, 350, 400ppm, KNO3 at 1.0%, 1.5%, 2.0%, H2SO4 at 0.5%, 1.0% and HCl 0.5%,1.0% for 100 seeds per treatment. Among the different germination inducing treatments, seeds treated with gibberellins responded well with high seed germination and vigorous seedling growth. The seeds treated with GA3 400 ppm recorded maximum germination and growth parameters like rate of germination, shoot length, root length, plant vigour, fresh and dry weight of which was followed GA3 350 ppm. The commencement of germination and 50 per cent germination was also earlier in the same treatment. The cuttings of C. paniculata took more time for root initiation up to four months and sprouting percent was moderate as compared to other easy to root species. Among different treatments, IBA 2000 ppm was found to be the best, which recorded the maximum shoot and also root parameters. The results of present investigation will be helpful for conservation of this endangered medicinal plant through propagation

Keywords: conservation, germination, growth, germination, propagation

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6388 Drug-Based Nanoparticles: Comparative Study of the Effect Drug Type on Release Kinetics and Cell Viability

Authors: Chukwudalu C. Nwazojie, Wole W. Soboyejo, John Obayemi, Ali Salifu Azeko, Sandra M. Jusu, Chinyerem M. Onyekanne

Abstract:

The conventional methods for the diagnosis and treatment of breast cancer include bulk systematic mammography, ultrasound, dynamic contrast-enhanced fast 3D gradient-echo (GRE) magnetic resonance imaging (MRI), surgery, chemotherapy, and radiotherapy. However, nanoparticles and drug-loaded polymer microspheres for disease (cancer) targeting and treatment have enormous potential to enhance the approaches that are used today. The goal is to produce an implantable biomedical device for localized breast cancer drug delivery within Africa and the world. The main advantage of localized delivery is that it reduces the amount of drug that is needed to have a therapeutic effect. Polymer blends of poly (D,L-lactide-co-glycolide) (PLGA) and polycaprolactone (PCL), which are biodegradable, is used as a drug excipient. This work focuses on the development of PLGA-PCL (poly (D,L-lactide-co-glycolide) (PLGA) blended with based injectable drug microspheres and are loaded with anticancer drugs (prodigiosin (PG), and paclitaxel (PTX) control) and also the conjugated forms of the drug functionalized with LHRH (luteinizing hormone-releasing hormone) (PG-LHRH, and PTX- LHRH control), using a single-emulsion solvent evaporation technique. The encapsulation was done in the presence of PLGA-PCL (as a polymer matrix) and poly-(vinyl alcohol) (PVA) (as an emulsifier). Comparative study of the various drugs release kinetics and degradation mechanisms of the PLGA-PCL with an encapsulated drug is achieved, and the implication of this study is for the potential application of prodigiosin PLGA-PCL loaded microparticles for controlled delivery of cancer drug and treatment to prevent the regrowth or locoregional recurrence, following surgical resection of triple-negative breast tumor.

Keywords: cancer, polymers, drug kinetics, nanoparticles

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6387 Analyzing the Impact of the COVID-19 Pandemic on Clinicians’ Perceptions of Resuscitation and Escalation Decision-Making Processes: Cross-Sectional Survey of Hospital Clinicians in the United Kingdom

Authors: Michelle Hartanto, Risheka Suthantirakumar

Abstract:

Introduction Staff redeployment, increased numbers of acutely unwell patients requiring resuscitation decision-making conversations, visiting restrictions, and varying guidance regarding resuscitation for patients with COVID-19 disrupted clinicians’ management of resuscitation and escalation decision-making processes. While it was generally accepted that the COVID-19 pandemic disturbed numerous aspects of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process in the United Kingdom, a process which establishes a patient’s CPR status and treatment escalation plans, the impact of the pandemic on clinicians’ attitudes towards these resuscitation and decision-making conversations was unknown. This was the first study to examine the impact of the COVID-19 pandemic on clinicians’ knowledge, skills, and attitudes towards the ReSPECT process. Methods A cross-sectional survey of clinicians at one acute teaching hospital in the UK was conducted. A questionnaire with a defined five-point Likert scale was distributed and clinicians were asked to recall their pre-pandemic views on ReSPECT and report their current views at the time of survey distribution (May 2020, end of the first COVID-19 wave in the UK). Responses were received from 171 clinicians, and self-reported views before and during the pandemic were compared. Results Clinicians reported they found managing ReSPECT conversations more challenging during the pandemic, especially when conducted over the telephone with relatives, and they experienced an increase in negative emotions before, during, and after conducting ReSPECT conversations. Our findings identified that due to the pandemic there was now a need for clinicians to receive training and support in conducting resuscitation and escalation decision-making conversations over the telephone with relatives and managing these processes.

Keywords: cardiopulmonary resuscitation, COVID-19 pandemic, DNACPR discussion, education, recommended summary plan for emergency care and treatment, resuscitation order

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6386 Flocculation on the Treatment of Olive Oil Mill Wastewater: Pre-Treatment

Authors: G. Hodaifa, J. A. Páez, C. Agabo, E. Ramos, J. C. Gutiérrez, A. Rosal

Abstract:

Currently, the continuous two-phase decanter process used for olive oil production is the more internationally widespread. The wastewaters generated from this industry (OMW) is a real environmental problem because of its high organic load. Among proposed treatments for these wastewaters, the advanced oxidation technologies (Fenton process, ozone, photoFenton, etc.) are the most favourable. The direct application of these processes is somewhat expensive. Therefore, the application of a previous stage based on a flocculation-sedimentation operation is of high importance. In this research five commercial flocculants (three cationic, and two anionic) have been used to achieve the separation of phases (liquid clarified-sludge). For each flocculant, different concentrations (0-1000 mg/L) have been studied. In these experiments, sludge volume formed over time and the final water quality were determined. The final removal percentages of total phenols (11.3-25.1%), COD (5.6-20.4%), total carbon (2.3-26.5%), total organic carbon (1.50-23.8%), total nitrogen (1.45-24.8%), and turbidity (27.9-61.4%) were obtained. Also, the variation on the electric conductivity reduction percentage (1-8%) was determined. Finally, the best flocculants with highest removal percentages have been determined (QG2001 and Flocudex CS49).

Keywords: flocculants, flocculation, olive oil mill wastewater, water quality

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6385 The Different Effects of Mindfulness-Based Relapse Prevention Group Therapy on QEEG Measures in Various Severity Substance Use Disorder Involuntary Clients

Authors: Yu-Chi Liao, Nai-Wen Guo, Chun‑Hung Lee, Yung-Chin Lu, Cheng-Hung Ko

Abstract:

Objective: The incidence of behavioral addictions, especially substance use disorders (SUDs), is gradually be taken seriously with various physical health problems. Mindfulness-based relapse prevention (MBRP) is a treatment option for promoting long-term health behavior change in recent years. MBRP is a structured protocol that integrates formal meditation practices with the cognitive-behavioral approach of relapse prevention treatment by teaching participants not to engage in reappraisal or savoring techniques. However, considering SUDs as a complex brain disease, questionnaires and symptom evaluation are not sufficient to evaluate the effect of MBRP. Neurophysiological biomarkers such as quantitative electroencephalogram (QEEG) may improve accurately represent the curative effects. This study attempted to find out the neurophysiological indicator of MBRP in various severity SUD involuntary clients. Participants and Methods: Thirteen participants (all males) completed 8-week mindfulness-based treatment provided by trained, licensed clinical psychologists. The behavioral data were from the Severity of Dependence Scale (SDS) and Negative Mood Regulation Scale (NMR) before and afterMBRP treatment. The QEEG data were simultaneously recorded with executive attention tasks, called comprehensive nonverbal attention test(CNAT). The two-way repeated-measures (treatment * severity) ANOVA and independent t-test were used for statistical analysis. Results: Thirteen participants regrouped into high substance dependence (HS) and low substance dependence (LS) by SDS cut-off. The HS group showed more SDS total score and lower gamma wave in the Go/No Go task of CNAT at pretest. Both groups showed the main effect that they had a lower frontal theta/beta ratio (TBR) during the simple reaction time task of CNAT. The main effect showed that the delay errors of CNAT were lower after MBRP. There was no other difference in CNAT between groups. However, after MBRP, compared to LS, the HS group have resonant progress in improving SDS and NMR scores. The neurophysiological index, the frontal TBR of the HS during the Go/No Go task of CNATdecreased than that of the LS group. Otherwise, the LS group’s gamma wave was a significant reduction on the Go/No Go task of CNAT. Conclusion: The QEEG data supports the MBRP can restore the prefrontal function of involuntary addicts and lower their errors in executive attention tasks. However, the improvement of MBRPfor the addict with high addiction severity is significantly more than that with low severity, including QEEG’s indicators and negative emotion regulation. Future directions include investigating the reasons for differences in efficacy among different severity of the addiction.

Keywords: mindfulness, involuntary clients, QEEG, emotion regulation

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6384 Drying Kinetics, Energy Requirement, Bioactive Composition, and Mathematical Modeling of Allium Cepa Slices

Authors: Felix U. Asoiro, Meshack I. Simeon, Chinenye E. Azuka, Harami Solomon, Chukwuemeka J. Ohagwu

Abstract:

The drying kinetics, specific energy consumed (SEC), effective moisture diffusivity (EMD), flavonoid, phenolic, and vitamin C contents of onion slices dried under convective oven drying (COD) were compared with microwave drying (MD). Drying was performed with onion slice thicknesses of 2, 4, 6, and 8 mm; air drying temperatures of 60, 80, and 100°C for COD, and microwave power of 450 W for MD. A decrease in slice thickness and an increase in drying air temperature led to a drop in the drying time. As thickness increased from 2 – 8 mm, EMD rose from 1.1-4.35 x 10⁻⁸ at 60°C, 1.1-5.6 x 10⁻⁸ at 80°C, and 1.25-6.12 x 10⁻⁸ at 100°C with MD treatments yielding the highest mean value (6.65 x 10⁻⁸ m² s⁻¹) at 8 mm. Maximum SEC for onion slices in COD was 238.27 kWh/kg H₂O (2 mm thickness), and the minimum was 39.4 kWh/kg H₂O (8 mm thickness) whereas maximum during MD was 25.33 kWh/kg H₂O (8 mm thickness) and minimum, 18.7 kWh/kg H₂O (2 mm thickness). MD treatment gave a significant (p 0.05) increase in the flavonoid (39.42 – 64.4%), phenolic (38.0 – 46.84%), and vitamin C (3.7 – 4.23 mg 100 g⁻¹) contents, while COD treatment at 60°C and 100°C had positive effects on only vitamin C and phenolic contents, respectively. In comparison, the Weibull model gave the overall best fit (highest R²=0.999; lowest SSE=0.0002, RSME=0.0123, and χ²= 0.0004) when drying 2 mm onion slices at 100°C.

Keywords: allium cepa, drying kinetics, specific energy consumption, flavonoid, vitamin C, microwave oven drying

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6383 Assessment of the Effect of Ethanolic Leaf Extract of Annona squamosa L. on Den Induced Hepatocellular Carcinoma in Experimental Animals

Authors: Vanitha Varadharaj, Vijalakshmi Krishnamurthy

Abstract:

Annona squamosa Linn, commonly known as Sugar apple, belonging to the family Annonaceae, is said to show varied medicinal effects, including insecticide, antiovulatory and abortifacient. The alkaloid and flavonoids present in Annona squamosa leaf has proved to have antioxidant activity. The present work has been planned to investigate the effect of ethanolic leaf extract of Annona squamosa leaf on Den Induced wistar albino rats. The study was carried out to analyze the biochemical Parmeters like Total Proteins, Bilirubin, Enzymatic and Non –Enzymatic enzymes, Marker enzymes and Tumor markers in serum and also the histopathological studies in liver is carried out in control and DEN induced rats. Supplementation of ELAS (Ethanolic Leaf Extract Of Annona squamosa) reduced the liver weight and also reduced the tumour incidence. Chemoprevention group showed near normal values of bilirubin when compared with the control rats. Total protein was decreased in the cancer bearing group and on treatment with the extract the levels of protein were restored. Both in pre and post treatment group, the activities of enzymatic antioxidants such as superoxide dismutase, catalase, and Glutathione peroxidase were increased but in pre treated animals it was more effective than post treated animals. The non- enzymatic antioxidants such as vitamin C and vitamin E were brought back to normal level significantly in post and pre treated animals. Activities of marker enzymes such as SGOT, SGPT, ALP, γ GT were significantly elevated in the serum of cancer animals and the values returned to normal after treatment with the extract suggesting the hepato protective effect of the extract. Lipid peroxide was found to be elevated in the cancer induced group. This condition was brought back to the normal in the pre and post treated animals with ELAS. Histological examination also confirmed the anti- carcinogenic potential of ELAS, Cancer induced groups had a triple fold increase in their AFP values when compared to other groups. DEN treatment increased the level of AFP expression while ELAS partially counteracted the effect of it. So the scientific validation obtained from this study may pave way to many budding scientists to find new drugs from Annona squamosa for various ailments.

Keywords: annona squamosa, biochemical parmeters, cancer, leaf extract

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6382 Delusional Parasitosis (A Rare Primary Psychiatric Diagnosis)

Authors: Jaspinder Kaur, Jatinder Pal Singh

Abstract:

Introduction- Delusional parasitosis is a rare psychotic illness characterized by a fixed belief of manifesting a parasite in a body when in reality, it was not. Also known as Ekbom syndrome or delusional infestations, or acarophobia. Although the patient has no primary skin pathology, but all skin findings were secondary to skin manipulation by the patient itself, which is why up to 90% of patients first seek consultation from a dermatologist. Most commonly, it was seen in older people with female to male ratio is 2:1. For treatment, the patient first need to be investigated to rule all other possible causes, as Delusional parasitosis can be caused by Vitamin B12 deficiency, pellagra, hepatic and renal disease, diabetes mellitus, multiple sclerosis, and leprosy. When all possible causes ruled out, psychiatric referral to be done. Rule out other psychiatric comorbidities, and treatment should be done accordingly. Patient with delusional parasitosis responds well to second generation antipsychotics and need to continuous medication over years, and relapse is likely if treatment is stopped. Case Presentation- A 79-year-old female, belonging to lower socio-economic status, presented with complaints of itching sensation with erythematous patches over the scalp and multiple scratch excoriations lesion over the scalp, face and neck from the past 7-8 months. She had a feeling of small insect crawling under her skin and scalp area. To reduce the itching and kill the insect, she would scratch and squeeze her skin repeatedly. When the family tried to give her explanation that there was no insect in her body, she would not get convinced, rather got angry and abuse family members for not believing her. Gradually, her sleep would remain disturbed, she would be seen awake at night, seen to be scratching her skin, pull her scalp hair, even squeeze out her healed lesions. She collected her skin debris, scalp hairs and look out for insect. Because of her continuous illness, the patient started to remain sad and had crying spells. Her appetite decreased. She became socially isolated and stopped doing her activities of daily living. Family member’s first consulted dermatologist, investigated thoroughly with routine investigations, autoimmune and malignancy workup. As all investigations were normal, following which patient was referred for psychiatric evaluation. The patient was started on Tablet Olanzapine 2.5 mg, gradually increased to 7.5 mg. Over 1 month, there was reduction in itching, skin pricking. Lesions were gradually healed, and the patient continued to take other dermatological medications and ointment and was in regular follow up with psychiatric liaison from past 2 months with 70-80 % improvement in her symptoms. Conclusion- Delusional parasitosis is a psychiatric disorder of insidious onset, seen commonly in middle and old age people. Both psychiatric and dermatology consultation liaison will help the patient for an early diagnosis and adequate treatment. If a primary psychiatric diagnosis, the patient respond well to second generation antipsychotics but always require a further evaluation and treatment management if it is secondary to some physical or other psychiatric comorbidity.

Keywords: delusional parasitosis, delusional infestations, rare, primary psychiatric diagnosis, antipsychotic agents

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6381 Tracking of Intramuscular Stem Cells by Magnetic Resonance Diffusion Weighted Imaging

Authors: Balakrishna Shetty

Abstract:

Introduction: Stem Cell Imaging is a challenging field since the advent of Stem Cell treatment in humans. Series of research on tagging and tracking the stem cells has not been very effective. The present study is an effort by the authors to track the stem cells injected into calf muscles by Magnetic Resonance Diffusion Weighted Imaging. Materials and methods: Stem Cell injection deep into the calf muscles of patients with peripheral vascular disease is one of the recent treatment modalities followed in our institution. 5 patients who underwent deep intramuscular injection of stem cells as treatment were included for this study. Pre and two hours Post injection MRI of bilateral calf regions was done using 1.5 T Philips Achieva, 16 channel system using 16 channel torso coils. Axial STIR, Axial Diffusion weighted images with b=0 and b=1000 values with back ground suppression (DWIBS sequence of Philips MR Imaging Systems) were obtained at 5 mm interval covering the entire calf. The invert images were obtained for better visualization. 120ml of autologous bone marrow derived stem cells were processed and enriched under c-GMP conditions and reduced to 40ml solution containing mixture of above stem cells. Approximately 40 to 50 injections, each containing 0.75ml of processed stem cells, was injected with marked grids over the calf region. Around 40 injections, each of 1ml normal saline, is injected into contralateral leg as control. Results: Significant Diffusion hyper intensity is noted at the site of injected stem cells. No hyper intensity noted before the injection and also in the control side where saline was injected conclusion: This is one of the earliest studies in literature showing diffusion hyper intensity in intramuscularly injected stem cells. The advantages and deficiencies in this study will be discussed during the presentation.

Keywords: stem cells, imaging, DWI, peripheral vascular disease

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