Search results for: type of foundation
6063 The Management of Care by People with Type 2 Diabetes versus the Professional Care at Primary Health Care in Brazil
Authors: Nunila Ferreira de Oliveira, Silvana Martins Mishima
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Diabetes mellitus type 2 (DM2) prevalence, is increasing on the world, in Brazil is considered a public health problem. Treatment focuses on glycemic control depending primarily of lifestyle changes - not drug treatment (NDT), may involve drug therapy (DT) and requires continuous health monitoring. In Brazil this monitoring is performed by the Unified Health System (SUS) through Primary Health Care (PHC), which stimulate people with DM2 empowerment for care management. SUS was approved in 1988 and the PHC operationalization was strengthened with the creation of the Family Health Strategy (FHS) in 1994. Our aim was to analyze the people with DM2 participation in front of the care management health monitoring in the FHS. Qualitative research was carried out through non-participant observation of attendance of 25 people with DM2 in the FHS and interviewed at home. Ethical guidelines were followed. It was found that people with DM2 only follow professionals’ recommendations that make sense according to their own conceptions of health/disease; most of them emphasize the importance of (DT) with little emphasis on the NDT, was found great difficulty in the NDT and lack of knowledge about the disease and care. As regards monitoring the FHS, were observed therapeutic practices based on the bio medical model, although the APS search for another care perspective; NDT is not systematically accompanied by the health team and takes place a few educational activities on the DM2 in the FHS, with low user adoption. The work of the FHS is done by multidisciplinary teams, but we see the need for greater participation of nurses in clinical-care follow-up of this population and may also act in adapting to the NDT. Finally we emphasize the need for professional practices that consider the difficulties to care management by people with DM2, especially because of the NDT. It is noticed that the measures recommended by the FHS professionals are not always developed by people with DM2. We must seek the empowerment of people with DM2 to manage the form of care associated with the FHS team, seeking to reduce the incidence of complications and higher quality of life.Keywords: diabetes mellitus, primary health care, nursing, management of care
Procedia PDF Downloads 4566062 Breaking the Silence and Rewriting the Script
Authors: Carlette Groome
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This paper examined the role of drama in the lives of four women. The researcher concluded that drama can be an avenue of healing and could be an effective means of social work intervention in the communities as well as female empowerment. The participants in the study were able to, through the dramatic process; re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed. The research conducted examined the role of drama in the lives of four women living in volatile communities in Jamaica, who were each exposed to violence in one, or multiple, forms. The women were trained by Sistren Theatre Collective in the use of drama for education (edutainment), and were actresses in Sistren's street theatre drama group. Using their own personal and collective experiences, they used drama to raise social consciousness at the community level, about violence and other issues affecting women. The study employed a narrative case study approach and was grounded in a constructivist paradigm. This paradigm was coupled with a basic interpretive qualitative method and the concept of the reflective practitioner provided the foundation for the analysis. Through individual conversations with the women, themes of abuse, resilience, self- esteem, and empowerment arose sharply. The women explored drama and understood it to be instrumental in healing different aspects of their lives. Also, through the dramatic process; they were able to re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed.Keywords: women, drama, healing, community
Procedia PDF Downloads 3406061 Beliefs on Reproduction of Women in Fish Port Community: An Explorative Study on the Beliefs on Conception, Childbirth, and Maternal Care of Women in Navotas Fish Port Community
Authors: Marie Kristel A. Gabawa
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The accessibility of health programs, specifically family planning programs and maternal and child health care (FP/MCH), are generally low in urban poor communities. Moreover, most of FP/MCH programs are directed toward medical terms that are usually not included in ideation of the body of urban poor dwellers. This study aims to explore the beliefs on reproduction that will encompass, but not limited to, beliefs on conception, pregnancy, and maternal and child health care. The site of study will be the 2 barangays of North Bay Boulevard South 1 (NBBS1) and North Bay Boulevard South 2 (NBBS2). These 2 barangays are the nearest residential community within the Navotas Fish Port Complex (NFPC). Data gathered will be analyzed using grounded-theory method of analysis, with the theories of cultural materialism and equity feminism as foundation. Survey questionnaires, key informant interviews, and focus group discussions will be utilized in gathering data. Further, the presentation of data will be recommended to health program initiators and use the data gathered as a tool to customize FP/MCH programs to the perception and beliefs of women residing in NBBS1and NBBS2, and to aid any misinformation for FP/MCH techniques.Keywords: beliefs on reproduction, fish port community, family planning, maternal and child health care, Navotas
Procedia PDF Downloads 2596060 The Next Generation’s Learning Ability, Memory, as Well as Cognitive Skills Is under the Influence of Paternal Physical Activity (An Intergenerational and Trans-Generational Effect): A Systematic Review and Meta-Analysis
Authors: Parvin Goli, Amirhosein Kefayat, Rezvan Goli
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Background: It is well established that parents can influence their offspring's neurodevelopment. It is shown that paternal environment and lifestyle is beneficial for the progeny's fitness and might affect their metabolic mechanisms; however, the effects of paternal exercise on the brain in the offspring have not been explored in detail. Objective: This study aims to review the impact of paternal physical exercise on memory and learning, neuroplasticity, as well as DNA methylation levels in the off-spring's hippocampus. Study design: In this systematic review and meta-analysis, an electronic literature search was conducted in databases including PubMed, Scopus, and Web of Science. Eligible studies were those with an experimental design, including an exercise intervention arm, with the assessment of any type of memory function, learning ability, or any type of brain plasticity as the outcome measures. Standardized mean difference (SMD) and 95% confidence intervals (CI) were computed as effect size. Results: The systematic review revealed the important role of environmental enrichment in the behavioral development of the next generation. Also, offspring of exercised fathers displayed higher levels of memory ability and lower level of brain-derived neurotrophic factor. A significant effect of paternal exercise on the hippocampal volume was also reported in the few available studies. Conclusion: These results suggest an intergenerational effect of paternal physical activity on cognitive benefit, which may be associated with hippocampal epigenetic programming in offspring. However, the biological mechanisms of this modulation remain to be determined.Keywords: hippocampal plasticity, learning ability, memory, parental exercise
Procedia PDF Downloads 2096059 Periodontal Soft Tissue Sculpturing and Use of Interim Appliance for Rehabilitation of Anterior Edentulousness: Case Report
Authors: Hande Yesil, Seda Aycan Altan, M. Vehbi Bal, Alper Uyar, O. Cumhur Sipahi
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Purpose: Fixed partial dentures (FPDs) must fulfill functional requirements such as phonetics, chewing efficiency and esthetics especially in the anterior region. A convex type tissue surface is usually recommended for pontics of FPDs. That pontic design also provides suitable oral hygiene and ease of cleaning. However, high esthetic requirements and correct emergence profile are not always achievable because of the convex shape of adjacent soft tissues. Therefore, the ovate type pontic which fulfills the high esthetic demands of the patients may be a good alternative to the modified ridge lap pontic design. Clinical Report: A female patient referred with the complaint of anterior upper edentulousness. In the oral examination it was determined that teeth 11, 12, 21, 22 were deficient. A thick and convex gingival tissue that may cause aesthetic problems was also observed.. Periodontal augmentation surgery was performed to ensure proper papillary configuration and gingival contour. An interim removable partial denture (IRPD) which applied pressure to operated gingival tissues was fabricated postoperatively. The IRPD was used for 4 weeks and after completion of tissue sculpting, the permanent FPD with an ovate pontic was fabricated and cemented. After a follow-up period of 6 months, not any esthetical and hygienic problem was detected and the patient was satisfied with her prosthesis. Conclusion: It was concluded that shaping of gingival contours with IRPD and use of a FPD with ovate pontic fulfills all esthetic and hygienic requirements.Keywords: interim appliance, ovate pontic, tissue sculpturing, fixed partial denture
Procedia PDF Downloads 2816058 Study on Metabolic and Mineral Balance, Oxidative Stress and Cardiovascular Risk Factors in Type 2 Diabetic Patients on Different Therapy
Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca
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Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.Keywords: cardiovascular risk, homocysteine, malondialdehyde, metformin, minerals, type 2 diabetes, vitamin B12
Procedia PDF Downloads 3196057 Seismic Reinforcement of Existing Japanese Wooden Houses Using Folded Exterior Thin Steel Plates
Authors: Jiro Takagi
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Approximately 90 percent of the casualties in the near-fault-type Kobe earthquake in 1995 resulted from the collapse of wooden houses, although a limited number of collapses of this type of building were reported in the more recent off-shore-type Tohoku Earthquake in 2011 (excluding direct damage by the Tsunami). Kumamoto earthquake in 2016 also revealed the vulnerability of old wooden houses in Japan. There are approximately 24.5 million wooden houses in Japan and roughly 40 percent of them are considered to have the inadequate seismic-resisting capacity. Therefore, seismic strengthening of these wooden houses is an urgent task. However, it has not been quickly done for various reasons, including cost and inconvenience during the reinforcing work. Residents typically spend their money on improvements that more directly affect their daily housing environment (such as interior renovation, equipment renewal, and placement of thermal insulation) rather than on strengthening against extremely rare events such as large earthquakes. Considering this tendency of residents, a new approach to developing a seismic strengthening method for wooden houses is needed. The seismic reinforcement method developed in this research uses folded galvanized thin steel plates as both shear walls and the new exterior architectural finish. The existing finish is not removed. Because galvanized steel plates are aesthetic and durable, they are commonly used in modern Japanese buildings on roofs and walls. Residents could feel a physical change through the reinforcement, covering existing exterior walls with steel plates. Also, this exterior reinforcement can be installed with only outdoor work, thereby reducing inconvenience for residents since they would not be required to move out temporarily during construction. The Durability of the exterior is enhanced, and the reinforcing work can be done efficiently since perfect water protection is not required for the new finish. In this method, the entire exterior surface would function as shear walls and thus the pull-out force induced by seismic lateral load would be significantly reduced as compared with a typical reinforcement scheme of adding braces in selected frames. Consequently, reinforcing details of anchors to the foundations would be less difficult. In order to attach the exterior galvanized thin steel plates to the houses, new wooden beams are placed next to the existing beams. In this research, steel connections between the existing and new beams are developed, which contain a gap for the existing finish between the two beams. The thin steel plates are screwed to the new beams and the connecting vertical members. The seismic-resisting performance of the shear walls with thin steel plates is experimentally verified both for the frames and connections. It is confirmed that the performance is high enough for bracing general wooden houses.Keywords: experiment, seismic reinforcement, thin steel plates, wooden houses
Procedia PDF Downloads 2266056 Signal Transduction in a Myenteric Ganglion
Authors: I. M. Salama, R. N. Miftahof
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A functional element of the myenteric nervous plexus is a morphologically distinct ganglion. Composed of sensory, inter- and motor neurons and arranged via synapses in neuronal circuits, their task is to decipher and integrate spike coded information within the plexus into regulatory output signals. The stability of signal processing in response to a wide range of internal/external perturbations depends on the plasticity of individual neurons. Any aberrations in this inherent property may lead to instability with the development of a dynamics chaos and can be manifested as pathological conditions, such as intestinal dysrhythmia, irritable bowel syndrome. The aim of this study is to investigate patterns of signal transduction within a two-neuronal chain - a ganglion - under normal physiological and structurally altered states. The ganglion contains the primary sensory (AH-type) and motor (S-type) neurons linked through a cholinergic dendro somatic synapse. The neurons have distinguished electrophysiological characteristics including levels of the resting and threshold membrane potentials and spiking activity. These are results of ionic channel dynamics namely: Na+, K+, Ca++- activated K+, Ca++ and Cl-. Mechanical stretches of various intensities and frequencies are applied at the receptive field of the AH-neuron generate a cascade of electrochemical events along the chain. At low frequencies, ν < 0.3 Hz, neurons demonstrate strong connectivity and coherent firing. The AH-neuron shows phasic bursting with spike frequency adaptation while the S-neuron responds with tonic bursts. At high frequency, ν > 0.5 Hz, the pattern of electrical activity changes to rebound and mixed mode bursting, respectively, indicating ganglionic loss of plasticity and adaptability. A simultaneous increase in neuronal conductivity for Na+, K+ and Ca++ ions results in tonic mixed spiking of the sensory neuron and class 2 excitability of the motor neuron. Although the signal transduction along the chain remains stable the synchrony in firing pattern is not maintained and the number of discharges of the S-type neuron is significantly reduced. A concomitant increase in Ca++- activated K+ and a decrease in K+ in conductivities re-establishes weak connectivity between the two neurons and converts their firing pattern to a bistable mode. It is thus demonstrated that neuronal plasticity and adaptability have a stabilizing effect on the dynamics of signal processing in the ganglion. Functional modulations of neuronal ion channel permeability, achieved in vivo and in vitro pharmacologically, can improve connectivity between neurons. These findings are consistent with experimental electrophysiological recordings from myenteric ganglia in intestinal dysrhythmia and suggest possible pathophysiological mechanisms.Keywords: neuronal chain, signal transduction, plasticity, stability
Procedia PDF Downloads 3926055 The Role and Function of National Land Authority as Mediator in Land Dispute Settlements in Indonesia
Authors: Nia Kurniati, Efa Laela Fakhriah
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The regulation in Indonesia provides space for the land dispute to be settled outside the court by the government through National Land. In this case, the bureaucrat of Badan Pertanahan Nasional (BPN) acts as mediator to reach a fair agreement between the disputing parties. Land dispute is from a party who denies the ownership of the other party of a land and denies legal-technical facts written on land certificate published by BPN. Appointing the bureaucrat of BPN as mediator in dispute settlements may possibly create conflict of interest since the object. It has become a concern since bureaucrat of BPN acts as mediator, he will be bias and partial in assisting the dispute settlement, thus the spirit and purposes of mediation will be hampered. This issue triggers to be thoroughly examined further in a relation with the role and function of BPN as land dispute mediator. The methodology used in this research is a normative-legal one with qualitative-legal analytical method. The object of this research is in the form of random sampling of land dispute cases being occurred in some areas. Several principles in mediation have to be made as the base of the consideration to appoint bureaucrat of BPN as mediator since the mediator is an impartial third party, working with both disputing parties and assisting them to reach a fair resolution written in agreement as a foundation of land dispute settlement. The existence of BPN as mediator in land dispute settlement encounters conflict of interest which uphold legal uncertainty to act objectively.Keywords: Indonesia, land dispute, mediator, national land authority
Procedia PDF Downloads 3116054 Significant Influence of Land Use Type on Earthworm Communities but Not on Soil Microbial Respiration in Selected Soils of Hungary
Authors: Tsedekech Gebremeskel Weldmichael, Tamas Szegi, Lubangakene Denish, Ravi Kumar Gangwar, Erika Micheli, Barbara Simon
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Following the 1992 Earth Summit in Rio de Janeiro, soil biodiversity has been recognized globally as a crucial player in guaranteeing the functioning of soil and a provider of several ecosystem services essential for human well-being. The microbial fraction of the soil is a vital component of soil fertility as soil microbes play key roles in soil aggregate formation, nutrient cycling, humification, and degradation of pollutants. Soil fauna, such as earthworms, have huge impacts on soil organic matter dynamics, nutrient cycling, and infiltration and distribution of water in the soil. Currently, land-use change has been a global concern as evidence accumulates that it adversely affects soil biodiversity and the associated ecosystem goods and services. In this study, we examined the patterns of soil microbial respiration (SMR) and earthworm (abundance, biomass, and species richness) across three land-use types (grassland, arable land, and forest) in Hungary. The objectives were i) to investigate whether there is a significant difference in SMR and earthworm (abundance, biomass, and species richness) among land-use types. ii) to determine the key soil properties that best predict the variation in SMR and earthworm communities. Soil samples, to a depth of 25 cm, were collected from the surrounding areas of seven soil profiles. For physicochemical parameters, soil organic matter (SOM), pH, CaCO₃, E₄/E₆, available nitrogen (NH₄⁺-N and NO₃⁻-N), potassium (K₂O), phosphorus (P₂O₅), exchangeable Ca²⁺, Mg²⁺, soil moisture content (MC) and bulk density were measured. The analysis of SMR was determined by basal respiration method, and the extraction of earthworms was carried out by hand sorting method as described by ISO guideline. The results showed that there was no statistically significant difference among land-use types in SMR (p > 0.05). However, the highest SMR was observed in grassland soils (11.77 mgCO₂ 50g⁻¹ soil 10 days⁻¹) and lowest in forest soils (8.61 mgCO₂ 50g⁻¹ soil 10 days⁻¹). SMR had strong positive correlations with exchangeable Ca²⁺ (r = 0.80), MC (r = 0.72), and exchangeable Mg²⁺(r = 0.69). We found a pronounced variation in SMR among soil texture classes (p < 0.001), where the highest value in silty clay loam soils and the lowest in sandy soils. This study provides evidence that agricultural activities can negatively influence earthworm communities, in which the arable land had significantly lower earthworm communities compared to forest and grassland respectively. Overall, in our study, land use type had minimal effects on SMR whereas, earthworm communities were profoundly influenced by land-use type particularly agricultural activities related to tillage. Exchangeable Ca²⁺, MC, and texture were found to be the key drivers of the variation in SMR.Keywords: earthworm community, land use, soil biodiversity, soil microbial respiration, soil property
Procedia PDF Downloads 1416053 A Convergent Interacting Particle Method for Computing Kpp Front Speeds in Random Flows
Authors: Tan Zhang, Zhongjian Wang, Jack Xin, Zhiwen Zhang
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We aim to efficiently compute the spreading speeds of reaction-diffusion-advection (RDA) fronts in divergence-free random flows under the Kolmogorov-Petrovsky-Piskunov (KPP) nonlinearity. We study a stochastic interacting particle method (IPM) for the reduced principal eigenvalue (Lyapunov exponent) problem of an associated linear advection-diffusion operator with spatially random coefficients. The Fourier representation of the random advection field and the Feynman-Kac (FK) formula of the principal eigenvalue (Lyapunov exponent) form the foundation of our method implemented as a genetic evolution algorithm. The particles undergo advection-diffusion and mutation/selection through a fitness function originated in the FK semigroup. We analyze the convergence of the algorithm based on operator splitting and present numerical results on representative flows such as 2D cellular flow and 3D Arnold-Beltrami-Childress (ABC) flow under random perturbations. The 2D examples serve as a consistency check with semi-Lagrangian computation. The 3D results demonstrate that IPM, being mesh-free and self-adaptive, is simple to implement and efficient for computing front spreading speeds in the advection-dominated regime for high-dimensional random flows on unbounded domains where no truncation is needed.Keywords: KPP front speeds, random flows, Feynman-Kac semigroups, interacting particle method, convergence analysis
Procedia PDF Downloads 466052 School as a Space of Power: A Foucauldian Critique
Authors: Yildirim Ortaoglan
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The attempt to make thought school-like by fitting it into various frameworks with the institutionalization of it is almost simultaneous with philosophy itself. What once sprouted in the “academia” of old has institutionalized under the enlightenment's light, becoming the fundamental space reflecting the spirit of its age. However, the shift from the thinking temple where truth's knowledge was sought to functional spaces where power/power relations are constructed indicates a significant rupture in the meaning of school. Therefore, a genealogical inquiry into the meaning of the school can provide us with a path toward understanding how it should be approached in contemporary times. From this perspective, it is essential to highlight how power/power relations operate in the school in terms of disciplinary practices, temporal management, and spatial organization to construct a distinct subjectivation. Recognizing that the changing and evolving nature of education is related to the structure of space can be understood by revealing how disciplinary power and bio-power, two fundamental aspects of genealogical research, operate. In disciplinary power, the relationship of the subject with discipline, temporal management, and space is about improvement and normalization, while in biopower, it manifests in maximizing utility, increasing free time, and constructing spaces that seem more vital. These indicators not only facilitate the formation of students as a subjectivation but also enable the condition of the possibility of power/power relations. Because power is not applied to subjects but used by them for passage, and behind this lies the idea that the individual is already one of the components of power. As one of the components of power, in terms of subjectivation type, the student is one of the primary targets of power relations. Therefore, conducting a genealogical inquiry of the student as a type of subjectivation and the school as its living area from the philosophical foundations of education may offer a new opportunity for thinking about the contemporary crisis of thought. Within the framework of this possibility, our investigation will consider which aspects of the school and the student, brought together for educational purposes, can be thought of within and beyond power/power relations.Keywords: power, education, space, school, student, discipline
Procedia PDF Downloads 586051 Ground Deformation Module for the New Laboratory Methods
Authors: O. Giorgishvili
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For calculation of foundations one of the important characteristics is the module of deformation (E0). As we all know, the main goal of calculation of the foundations of buildings on deformation is to arrange the base settling and difference in settlings in such limits that do not cause origination of cracks and changes in design levels that will be dangerous to standard operation in the buildings and their individual structures. As is known from the literature and the practical application, the modulus of deformation is determined by two basic methods: laboratory method, soil test on compression (without the side widening) and soil test in field conditions. As we know, the deformation modulus of soil determined by field method is closer to the actual modulus deformation of soil, but the complexity of the tests to be carried out and the financial concerns did not allow determination of ground deformation modulus by field method. Therefore, we determine the ground modulus of deformation by compression method without side widening. Concerning this, we introduce a new way for determination of ground modulus of deformation by laboratory order that occurs by side widening and more accurately reflects the ground modulus of deformation and more accurately reflects the actual modulus of deformation and closer to the modulus of deformation determined by the field method. In this regard, we bring a new approach on the ground deformation detection laboratory module, which is done by widening sides. The tests and the results showed that the proposed method of ground deformation modulus is closer to the results that are obtained in the field, which reflects the foundation's work in real terms more accurately than the compression of the ground deformation module.Keywords: build, deformation modulus, foundations, ground, laboratory research
Procedia PDF Downloads 3696050 Facile Route for the Synthesis of NiO/ZnO Nanocomposite Used in Gas Sensors
Authors: Roussin Lontio Fomekong, John Lambi Ngolui, Arnaud Dercorte
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Current years have seen increased interest in the synthesis of p/n metal oxide-based nano composites and their great potential in advanced applications, such as opto electronics, photo catalysis and gas sensors. The superior functional performances of the system combining p-type and n-types semiconducting oxyde in comparison to the corresponding single-phase metal oxides are mainly ascribed to the build-up of an inner electric field at the p/n junction interface.Keywords: nanocomposite, semiconductors, p-n, heterojunction
Procedia PDF Downloads 5316049 Numerical and Experimental Investigation of Distance Between Fan and Coil Block in a Fin and Tube Air Cooler Heat Exchanger
Authors: Feyza Şahi̇n, Harun Deni̇zli̇, Mustafa Zabun, Hüseyi̇n OnbaşIoğli
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Heat exchangers are devices that are widely used to transfer heat between fluids due to their temperature differences. As a type of heat exchanger, air coolers are heat exchangers that cool the air as it passes through the fins of the heat exchanger by transferring heat to the refrigerant in the coil tubes of the heat exchanger. An assembled fin and tube heat exchanger consists of a coil block and a casing with a fan mounted on it. The term “Fan hood” is used to define the distance between the fan and the coil block. Air coolers play a crucial role in cooling systems, and their heat transfer performance can vary depending on design parameters. These parameters can be related to the air side or the internal fluid side. For airside efficiency, the distance between the fan and the coil block affects the performance by creating dead zones at the corners of the casing and maldistribution of airflow. Therefore, a detailed study of the effect of the fan hood on the evaporator and the optimum fan hood distance is necessary for an efficient air cooler design. This study aims to investigate the value of the fan hood in a fin and tube-type air cooler heat exchanger through computational fluid dynamics (CFD) simulations and experimental investigations. CFD simulations will be used to study the airflow within the fan hood. These simulations will provide valuable insights to optimize the design of the fan hood. In addition, experimental tests will be carried out to validate the CFD results and to measure the performance of the fan hood under real conditions. The results will help us to understand the effect of fan hood design on evaporator efficiency and contribute to the development of more efficient cooling systems. This study will provide essential information for evaporator design and improving the energy efficiency of cooling systems.Keywords: heat exchanger, fan hood, heat exchanger performance, air flow performance
Procedia PDF Downloads 776048 A Proposed Treatment Protocol for the Management of Pars Interarticularis Pathology in Children and Adolescents
Authors: Paul Licina, Emma M. Johnston, David Lisle, Mark Young, Chris Brady
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Background: Lumbar pars pathology is a common cause of pain in the growing spine. It can be seen in young athletes participating in at-risk sports and can affect sporting performance and long-term health due to its resistance to traditional management. There is a current lack of consensus of classification and treatment for pars injuries. Previous systems used CT to stage pars defects but could not assess early stress reactions. A modified classification is proposed that considers findings on MRI, significantly improving early treatment guidance. The treatment protocol is designed for patients aged 5 to 19 years. Method: Clinical screening identifies patients with a low, medium, or high index of suspicion for lumbar pars injury using patient age, sport participation and pain characteristics. MRI of the at-risk cohort enables augmentation of existing CT-based classification while avoiding ionising radiation. Patients are classified into five categories based on MRI findings. A type 0 lesion (stress reaction) is present when CT is normal and MRI shows high signal change (HSC) in the pars/pedicle on T2 images. A type 1 lesion represents the ‘early defect’ CT classification. The group previously referred to as a 'progressive stage' defect on CT can be split into 2A and 2B categories. 2As have HSC on MRI, whereas 2Bs do not. This distinction is important with regard to healing potential. Type 3 lesions are terminal stage defects on CT, characterised by pseudarthrosis. MRI shows no HSC. Results: Stress reactions (type 0) and acute fractures (1 and 2a) can heal and are treated in a custom-made hard brace for 12 weeks. It is initially worn 23 hours per day. At three weeks, patients commence basic core rehabilitation. At six weeks, in the absence of pain, the brace is removed for sleeping. Exercises are progressed to positions of daily living. Patients with continued pain remain braced 23 hours per day without exercise progression until becoming symptom-free. At nine weeks, patients commence supervised exercises out of the brace for 30 minutes each day. This allows them to re-learn muscular control without rigid support of the brace. At 12 weeks, bracing ceases and MRI is repeated. For patients with near or complete resolution of bony oedema and healing of any cortical defect, rehabilitation is focused on strength and conditioning and sport-specific exercise for the full return to activity. The length of this final stage is approximately nine weeks but depends on factors such as development and level of sports participation. If significant HSC remains on MRI, CT scan is considered to definitively assess cortical defect healing. For these patients, return to high-risk sports is delayed for up to three months. Chronic defects (2b and 3) cannot heal and are not braced, and rehabilitation follows traditional protocols. Conclusion: Appropriate clinical screening and imaging with MRI can identify pars pathology early. In those with potential for healing, we propose hard bracing and appropriate rehabilitation as part of a multidisciplinary management protocol. The validity of this protocol will be tested in future studies.Keywords: adolescents, MRI classification, pars interticularis, treatment protocol
Procedia PDF Downloads 1536047 Evolution of Approaches to Cost Calculation in the Conditions of the Modern Russian Economy
Authors: Elena Tkachenko, Vladimir Kokh, Alina Osipenko, Vladislav Surkov
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The modern period of development of Russian economy is fraught with a number of problems related to limitations in the use of traditional planning and financial management tools. Restrictions in the use of foreign software when performing an order of the Russian Government, on the one hand, and sanctions limiting the support of the major ERP and MRP II systems in the Russian Federation, on the other hand, entail the necessity to appeal to the basics of developing budgeting and analysis systems for industrial enterprises. Thus, cost calculation theory becomes the theoretical foundation for the development of industrial cost management systems. Based on the foregoing, it would be fair to make an assumption that the development of a working managerial accounting model on an industrial enterprise using an automated enterprise resource management system should rest upon the concept of the inevitability of alterations of business processes. On the other hand, optimized business processes make the architecture of financial analytics more transparent and permit the use of all the benefits of data cubes. The metrics and indicator slices provide online assessment of the state of key business processes at a given moment of time, which improves the quality of managerial decisions considerably. Therefore, the bilateral sanctions situation boosted the development of corporate business analytics and took industrial companies to the next level of understanding of business processes.Keywords: cost culculation, ERP, OLAP, modern Russian economy
Procedia PDF Downloads 2216046 New Ethanol Method for Soft Tissue Imaging in Micro-CT
Authors: Matej Patzelt, Jan Dudak, Frantisek Krejci, Jan Zemlicka, Vladimir Musil, Jitka Riedlova, Viktor Sykora, Jana Mrzilkova, Petr Zach
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Introduction: Micro-CT is well used for examination of bone structures and teeth. On the other hand visualization of the soft tissues is still limited. The goal of our study was to create a new fixation method for soft tissue imaging in micro-CT. Methodology: We used organs of 18 mice - heart, lungs, kidneys, liver and brain, which we fixated in ethanol after meticulous preparation. We fixated organs in different concentrations of ethanol and for different period of time. We used three types of ethanol concentration - 97%, 50% and ascending ethanol concentration (25%, 50%, 75%, 97% each for 12 hours). Fixated organs were scanned after 72 hours, 168 hours and 336 hours period of fixation. We scanned all specimens in micro-CT MARS (Medipix All Resolution System). Results: Ethanol method provided contrast enhancement in all studied organs in all used types of fixation. Fixation in 97% ethanol provided very fast fixation and the contrast among the tissues was visible already after 72 hours of fixation. Fixation for the period of 168 and 336 hours gave better details, especially in lung tissue, where alveoli were visualized. On the other hand, this type of fixation caused organs to petrify. Fixation in 50% ethanol provided best results in 336 hours fixation, details were visualized better than in 97% ethanol and samples were not as hard as in fixation in 97% ethanol. Best results were obtained in fixation in ascending ethanol concentration. All organs were visualized in great details, best-visualized organ was heart, where trabeculae and valves were visible. In this type of fixation, organs stayed soft for whole time. Conclusion: New ethanol method is a great option for soft tissue fixation as well as the method for enhancing contrast among tissues in organs. The best results were obtained with fixation of the organs in ascending ethanol concentration, the best visualized organ was the heart.Keywords: x-ray imaging, small animals, ethanol, ex-vivo
Procedia PDF Downloads 3216045 An Investigation of the Science Process Skills of 48-66 Months Old Children
Authors: Nilüfer Kuru, Berrin Akman
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In this study, science process skills of children with ages varying between 48-months and 66-months are analyzed. Science process skills of children are investigated in terms of factors including gender of children, attendance of children to the previous educational institution and duration of their attendance, educational background of their parents, ages of children and teachers, professional experience of teachers, educational background, and department of graduation of teachers, type of pre-school education institution of teachers and children. Sample of research consists of 250 children aged between 48-months and 66-months who attend state and private kindergartens under the Ministry of National Education, nursery classes of elementary schools and kindergartens of establishments in central districts of Ankara and 50 teachers who serve in these children’s classes. Science Observation Form, reached from the website of Alaska Department of Education & Early, are analyzed in terms of language, content, construct validity, and reliability by the researchers. Additionally, Personal Information Form is also developed by the researchers. Data obtained in the study are analyzed with SPSS 16.0 package program to obtain percentage and frequency, Kruskal Wallis H-test, and Mann- Whitney U test, which are one of the non-parametric tests, are used. Within the context of this study it has been seen that independent variables of age, type of school attending and status of attendance to pre-school education, educational background of children’s father are meaningful expositive in gaining science process skills for children. It has been seen that period of service of teachers, duration of attendance to pre-school education for children, gender of children and educational background of children’s mother are not meaningful expositive in gaining science process skills for children.Keywords: preschool, science process skills, early childhood education, science
Procedia PDF Downloads 3696044 Synthesis and Characterization of Some 1, 2, 3-Triazole Derivatives Containing the Chalcone Moiety and Evaluation for their Antimicrobial and Antioxidant Activity
Authors: Desta Gebretekle Shiferaw, Balakrishna Kalluraya
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Triazoles are basic five-membered ring heterocycles with an unsaturated, six-delocalized electron ring system. Since the dawn of click chemistry, triazoles have represented a functional heterocyclic core that has been the foundation of medicinal chemistry. The compounds with 1,2,3-triazole rings can be used in several fields, including medicine, organic synthesis, polymer chemistry, fluorescent imaging, horticulture, and industries, to name a few. Besides that, they found it to have health applications in the prevention and reduction of the risk of diseases, such as anti-cancer, antimicrobial, antiviral, and anti-inflammatory properties. Here, we present the synthesis of twelve 1,2,3-triazolyl chalcone derivatives (4a–l), which were produced in high yields by coupling substituted aldehydes and triazolyl acetophenone (3a–d) in ethanol. The title products were characterized by physicochemical, infrared, nuclear magnetic resonance, and mass spectral methods. The in vitro tests were used to evaluate the antioxidant and antimicrobial activity of each of the prepared molecules. The preliminary assessment and 2,2-diphenyl-1-picrylhydrazyl activity of the title compounds showed significantly higher antibacterial activity and moderate-to-good antifungal and antioxidant activities compared to their standards. This work presents the synthesis of triazolyl chalcone derivatives and their biological activity. Based on the findings, these compounds could be used as lead compounds in antimicrobial and antioxidant research in the future.Keywords: antibacterial activity, antifungal activity, antioxidant activity, chalcone, 1, 2, 3-triazole
Procedia PDF Downloads 1266043 Empowering Through Photovoice and Entrepreneurship: A Lived Experience of Alcohol-Induced Disorder and Recovery in Zambia
Authors: Rabson Banda
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This abstract delves into the transformative journey of Rabson Banda, a visionary leader in Zambia who has harnessed the power of photovoice, mental fitness, and entrepreneurship to combat substance use disorders in the face of limited job opportunities in Africa. Rabson's personal battle with alcohol-induced disorder serves as the foundation for his pioneering work in establishing Elevated Initiatives, a grassroots organization dedicated to empowering individuals struggling with addiction through innovative approaches. Through the lens of photovoice, Rabson Banda amplifies the voices of those affected by substance abuse, providing a platform for self-expression and healing. By intertwining mental fitness techniques and entrepreneurial skills, he equips individuals with the tools needed to break free from the cycle of addiction and chart a new path toward holistic wellness and economic independence. Rabson Banda's story embodies resilience, hope, and the unwavering belief in the transformative power of community-driven initiatives. His work not only addresses the immediate challenges of substance use disorders but also addresses the root causes of addiction by advocating for increased job opportunities and economic empowerment in Zambia and across Africa for decent job creation and Entrepreneurship: A Lived Experience of Alcohol-Induced Disorder and Recovery in Zambia.Keywords: mental fitness, entrepreneurship, photovoice, descent jobs
Procedia PDF Downloads 406042 Combating Malaria: A Drug Discovery Approach Using Thiazole Derivatives Against Prolific Parasite Enzyme PfPKG
Authors: Hari Bezwada, Michelle Cheon, Ryan Divan, Hannah Escritor, Michelle Kagramian, Isha Korgaonkar, Maya MacAdams, Udgita Pamidigantam, Richard Pilny, Eleanor Race, Angadh Singh, Nathan Zhang, LeeAnn Nguyen, Fina Liotta
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Malaria is a deadly disease caused by the Plasmodium parasite, which continues to develop resistance to current antimalarial drugs. In this research project, the effectiveness of numerous thiazole derivatives was explored in inhibiting the PfPKG, a crucial part of the Plasmodium life cycle. This study involved the synthesis of six thiazole-derived amides to inhibit the PfPKG pathway. Nuclear Magnetic Resonance (NMR) spectroscopy and Infrared (IR) spectroscopy were used to characterize these compounds. Furthermore, AutoDocking software was used to predict binding affinities of these thiazole-derived amides in silico. In silico, compound 6 exhibited the highest predicted binding affinity to PfPKG, while compound 5 had the lowest affinity. Compounds 1-4 displayed varying degrees of predicted binding affinity. In-vitro, it was found that compound 4 had the best percent inhibition, while compound 5 had the worst percent inhibition. Overall, all six compounds had weak inhibition (approximately 30-39% at 10 μM), but these results provide a foundation for future drug discovery experiments.Keywords: Medicinal Chemistry, Malaria, drug discovery, PfPKG, Thiazole, Plasmodium
Procedia PDF Downloads 986041 Layer-By-Layer Deposition of Poly(Ethylene Imine) Nanolayers on Polypropylene Nonwoven Fabric: Electrostatic and Thermal Properties
Authors: Dawid Stawski, Silviya Halacheva, Dorota Zielińska
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The surface properties of many materials can be readily and predictably modified by the controlled deposition of thin layers containing appropriate functional groups and this research area is now a subject of widespread interest. The layer-by-layer (lbl) method involves depositing oppositely charged layers of polyelectrolytes onto the substrate material which are stabilized due to strong electrostatic forces between adjacent layers. This type of modification affords products that combine the properties of the original material with the superficial parameters of the new external layers. Through an appropriate selection of the deposited layers, the surface properties can be precisely controlled and readily adjusted in order to meet the requirements of the intended application. In the presented paper a variety of anionic (poly(acrylic acid)) and cationic (linear poly(ethylene imine), polymers were successfully deposited onto the polypropylene nonwoven using the lbl technique. The chemical structure of the surface before and after modification was confirmed by reflectance FTIR spectroscopy, volumetric analysis and selective dyeing tests. As a direct result of this work, new materials with greatly improved properties have been produced. For example, following a modification process significant changes in the electrostatic activity of a range of novel nanocomposite materials were observed. The deposition of polyelectrolyte nanolayers was found to strongly accelerate the loss of electrostatically generated charges and to increase considerably the thermal resistance properties of the modified fabric (the difference in T50% is over 20°C). From our results, a clear relationship between the type of polyelectrolyte layer deposited onto the flat fabric surface and the properties of the modified fabric was identified.Keywords: layer-by-layer technique, polypropylene nonwoven, surface modification, surface properties
Procedia PDF Downloads 4356040 Potential Role of Arbuscular Mycorrhizal (AM) Fungi in CO₂-Sequestration During Bipartite Interaction with Host Plant Oryza Sativa
Authors: Sadhana Shukla, Pushplata Singh, Nidhi Didwania
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Arbuscular mycorrhizal (AM) fungi are a highly advantageous and versatile group of fungi that significantly contribute to the formation of soil organic matter by creating a demand for plant carbon (C) and distributing it through below-ground hyphal biomass, regardless of their substantial contribution in enhancing net primary productivity and accumulating additional photosynthetic fixed C in the soil. The genetic role of AM fungi in carbon cycling is largely unexplored. In our study, we propose that AM fungi significantly interact with the soil, particularly: the provision of photosynthates by plants. We have studied the expression of AM fungi genes involved in CO₂ sequestration during host-plant interaction was investigated by qPCR studies. We selected Rhizophagus proliferus (AM fungi) and Oryza sativa (Rice) (inoculated with or without 200ppg AMF inoculums per plant) and investigated the effect of AM fungi on soil organic carbon (SOC) and rice growth under field conditions. Results thus provided faster SOC turnover, 35% increased nutrient uptake in plants and pronounced hyphal biomass of AM fungi which enhanced soil carbon storage by 15% in comparison to uninoculated plants. This study will offer a foundation for delving into various carbon-soil studies while also advancing our comprehension of the relationship between AM fungi and the sustainability of agricultural ecosystems.Keywords: arbuscular mycorrhizal (AM) fungi, carbon sequestration, gene expression, soil health, plant development.
Procedia PDF Downloads 736039 An Industrial Steady State Sequence Disorder Model for Flow Controlled Multi-Input Single-Output Queues in Manufacturing Systems
Authors: Anthony John Walker, Glen Bright
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The challenge faced by manufactures, when producing custom products, is that each product needs exact components. This can cause work-in-process instability due to component matching constraints imposed on assembly cells. Clearing type flow control policies have been used extensively in mediating server access between multiple arrival processes. Although the stability and performance of clearing policies has been well formulated and studied in the literature, the growth in arrival to departure sequence disorder for each arriving job, across a serving resource, is still an area for further analysis. In this paper, a closed form industrial model has been formulated that characterizes arrival-to-departure sequence disorder through stable manufacturing systems under clearing type flow control policy. Specifically addressed are the effects of sequence disorder imposed on a downstream assembly cell in terms of work-in-process instability induced through component matching constraints. Results from a simulated manufacturing system show that steady state average sequence disorder in parallel upstream processing cells can be balanced in order to decrease downstream assembly system instability. Simulation results also show that the closed form model accurately describes the growth and limiting behavior of average sequence disorder between parts arriving and departing from a manufacturing system flow controlled via clearing policy.Keywords: assembly system constraint, custom products, discrete sequence disorder, flow control
Procedia PDF Downloads 1786038 Determinants of Consultation Time at a Family Medicine Center
Authors: Ali Alshahrani, Adel Almaai, Saad Garni
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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.Keywords: consultation, quality, medicine, clinics
Procedia PDF Downloads 2876037 Behavior of Laterally Loaded Multi-Helix Helical Piles Under Vertical Loading in Cohesive and Cohesionless Soils
Authors: Mona Fawzy Aldaghma
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Helical piles are gaining popularity as a viable deep foundation alternative due to their quick installation and multipurpose use in compression and tension. These piles are commonly used as foundations for constructions such as solar panels, wind turbines and offshore platforms. These structures typically transfer various combinations of loads to their helical-pile foundations, including axial and lateral loads. Further research is needed to determine the effects of loading patterns that may act on helical piles as compounds of axial compression and lateral stresses. Multi helical piles are used to increase the efficiency of these piles. In this study, it investigate the behavior of laterally loaded helical piles with multiple helices when subjected to vertical loading conditions in both cohesive and cohesionless soils. Two models of intermediate shaft rigidity are studied with either two or three helices. Additionally, the vertical loading conditions were altered between successive and simultaneous loading. The cohesionless soil is sand with medium density and the cohesive soil is clay with medium cohesion. The study will carried out with numerical analysis using PLAXIS 3D and will be verified by an experimental tests. The numerical simulations reveal that helical piles exhibit different behavior in cohesive soil compared to cohesionless soil.Keywords: helical piles, multi-helix, numerical modeling, PLAXIS 3D, cohesive soil, cohesionless soil, experimental
Procedia PDF Downloads 366036 Identifying the Influence of Vegetation Type on Multiple Green Roof Functions with a Field Experiment in Zurich
Authors: Lauren M. Cook, Tove A. Larsen
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Due to their potential to provide numerous ecosystem services, green roofs have been proposed as a solution to mitigate a growing list of environmental challenges, like urban flooding and urban heat island effect. Because of their cooling effect, green roofs placed below rooftop photovoltaic (PV) panels also have the potential to increase PV panel efficiency. Sedums, a type of succulent plant, are commonly used on green roofs because they are drought and heat tolerant. However, other plant species, such as grasses or plants with reflective properties, have been shown to reduce more runoff and cool the rooftop more than succulent species due to high evapotranspiration (ET) and reflectivity, respectively. The goal of this study is to evaluate whether vegetation with high ET or reflectivity can influence multiple co-benefits of the green roof. Four small scale green roofs in Zurich are used as an experiment to evaluate differences in (1) the timing and amount of runoff discharged from the roof, (2) the air temperature above the green roof, and (3) the temperature and efficiency of solar panels placed above the green roof. One grass species, Silene vulgaris, and one silvery species, Stachys byzantia, are compared to a baseline of Sedum album and black roof. Initial results from August to November 2019 show that the grass species has retained more cumulative runoff and led to a lower canopy temperature than the other species. Although the results are not yet statistically significant, they may suggest that plants with higher ET will have a greater effect on canopy temperature than plants with high reflectivity. Future work will confirm this hypothesis and evaluate whether it holds true for solar panel temperature and efficiency.Keywords: co-benefit estimation, green cities, green roofs, solar panels
Procedia PDF Downloads 1026035 Assessment of Dietary Patterns of Saudi Patients with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods
Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris
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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan
Procedia PDF Downloads 1646034 Outcome Analysis of Various Management Strategies for Ileal Perforation
Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda
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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management
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