Search results for: 3D treatment planning
9401 A Congenital Case of Dandy-Walker Malformation
Authors: Neerja Meena, Paresh Sukhani
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Dandy walker malformation is a generalised disorder of mesenchymal development that affect both the cerebellum and overlying meninges. Classically dandy-walker malformation consists of a triad of- 1:vermian and hemispheric cerebellar hypoplasia 2:cystic dilatation of 4th ventricle 3: enlarged posterior fossa with the upward migration of tentorium(lambdoid- torcular inversion). Clinical presentation: four months old female child with hydrocephalus and neurological symptoms. Generally- early death is common in classic dandy walker malformation. However, if it is relatively mild and uncomplicated by other CNS anomalies, intelligence can be normal and neurologic deficits minimal. Usually, VP shunting is the treatment of choice for this hydrocephalus. Conclusion: MRI is the modality of choice to diagnose posterior fossa malformation. However, it can be ruled out through using during the antenatal check as the prognosis of this malformation is not good; it's better to diagnose it inutero.Keywords: Dandy Walker, Mri, Earlydaignosis, Treatment
Procedia PDF Downloads 779400 Preparation and Quality Control of a Novel Radiolabeled Complex of 166ho for the Treatment of Somatostatin Receptor Expressing Tumours
Authors: H. Yousefnia, A. Golabi Dezfuli, S. Zolghadri, M. Hosntalab
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Peptide receptor radionuclide therapy is nowadays used for the treatment of various abnormalities with somatostatin receptors. In this study, 166Ho-DOTATOC was prepared and the best conditions for its radiolabeling was obtained. For this purpose, a certain of DOTATOC was added to a vial containing 166Ho. various experiments by varying ligand concentration, pH, temperature and time were performed to determine the best conditions. Radiochemical purity of the complex was assessed by instant thin layer chromatography method utilizing 0.9% NaCl as the mobile phase. 166Ho-DOTATOC was prepared with radiochemical purity of higher than 95% at the optimized condition (pH=4, temperature: 95° C, time:30 min). In 0.9% NaCl, free Ho cation was developed at Rf of 0.8 while the complex was remained at the front of the paper.Keywords: Ho-166, neuroendocrine, octreotide, quality control
Procedia PDF Downloads 3869399 A Comparative Study of the Use of Medicinal Plants and Conventional Medicine for the Treatment of Hepatitis B Virus in Ibadan Metropolis
Authors: Julius Adebayo John
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The objective of this study is to compare the use of medicinal plants and Conventional medicine intervention in the management of HBV among Ibadan populace. A purposive sampling technique was used to administer questionnaires at 2 places, namely, the University College Hospital and Total Healthcare Diagnostic Centre, Ibadan, where viral loads are carried out. A EuroQol (EQ – 5D) was adopted to collect data. Descriptive and inferential analyses were performed. Also, ANOVA, Correlation, charts, and tables were used. Findings revealed a high prevalence of HBV among female respondents and sample between ages 26years to 50years. Results showed that the majority discovered their health status through free HBV tests. Analysis indicated that the use of medicinal plant extract is cost-effective in 73% of cases. Rank order utility derived from medicinal plants is higher than other interventions. Correlation analysis performed for the current health status of respondents were significant at P<0.01 against the intervention management adopted (0.046), cost of treatment (0.549), utility (0.407) at P<0.00, duration of the treatment (0.604) at P<0.01; viral load before treatment (-0.142) not significant at P<0.01, the R2 (72.2%) showed the statistical variance in respondents current health status as explained by the independent variables. Respondents gained quality-adjusted life-years (QALYs) of between 1year to 3years. Suggestions were made for a public-private partnership effort against HBV with emphasis on periodic screening, viral load test subsidy, and free vaccination of people with –HBV status. Promoting phytomedicine through intensive research with strong regulation of herbal practitioners will go a long way in alleviating the burdens of the disease in society.Keywords: medicinal plant, HBV management interventions, utility, QALYs, ibadan metropolis
Procedia PDF Downloads 1559398 Electoral Mathematics and Asymmetrical Treatment to Political Parties: The Mexican Case
Authors: Verónica Arredondo, Miguel Martínez-Panero, Teresa Peña, Victoriano Ramírez
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The Mexican Chamber of Deputies is composed of 500 representatives: 300 of them elected by relative majority and another 200 ones elected through proportional representation in five electoral clusters (constituencies) with 40 representatives each. In this mixed-member electoral system, the seats distribution of proportional representation is not independent of the election by relative majority, as it attempts to correct representation imbalances produced in single-member districts. This two-fold structure has been maintained in the successive electoral reforms carried out along the last three decades (eight from 1986 to 2014). In all of them, the election process of 200 seats becomes complex: Formulas in the Law are difficult to understand and to be interpreted. This paper analyzes the Mexican electoral system after the electoral reform of 2014, which was applied for the first time in 2015. The research focuses on contradictions and issues of applicability, in particular situations where seats allocation is affected by ambiguity in the law and where asymmetrical treatment of political parties arises. Due to these facts, a proposal of electoral reform will be presented. It is intended to be simpler, clearer, and more enduring than the current system. Furthermore, this model is more suitable for producing electoral outcomes free of contradictions and paradoxes. This approach would allow a fair treatment of political parties and as a result an improved opportunity to exercise democracy.Keywords: electoral mathematics, electoral reform, Mexican electoral system, political asymmetry, proportional representation
Procedia PDF Downloads 2529397 Conventional Four Steps Travel Demand Modeling for Kabul New City
Authors: Ahmad Mansoor Stanikzai, Yoshitaka Kajita
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This research is a very essential towards transportation planning of Kabul New City. In this research, the travel demand of Kabul metropolitan area (Existing and Kabul New City) are evaluated for three different target years (2015, current, 2025, mid-term, 2040, long-term). The outcome of this study indicates that, though currently the vehicle volume is less the capacity of existing road networks, Kabul city is suffering from daily traffic congestions. This is mainly due to lack of transportation management, the absence of proper policies, improper public transportation system and violation of traffic rules and regulations by inhabitants. On the other hand, the observed result indicates that the current vehicle to capacity ratio (VCR) which is the most used index to judge traffic status in the city is around 0.79. This indicates the inappropriate traffic condition of the city. Moreover, by the growth of population in mid-term (2025) and long-term (2040) and in the case of no development in the road network and transportation system, the VCR value will dramatically increase to 1.40 (2025) and 2.5 (2040). This can be a critical situation for an urban area from an urban transportation perspective. Thus, by introducing high-capacity public transportation system and the development of road network in Kabul New City and integrating these links with the existing city road network, significant improvements were observed in the value of VCR.Keywords: Afghanistan, Kabul new city, planning, policy, urban transportation
Procedia PDF Downloads 3319396 The Effect of Feedstock Powder Treatment / Processing on the Microstructure, Quality, and Performance of Thermally Sprayed Titanium Based Composite Coating
Authors: Asma Salman, Brian Gabbitas, Peng Cao, Deliang Zhang
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The performance of a coating is strongly dependent upon its microstructure, which in turn is dependent on the characteristics of the feedstock powder. This study involves the evaluation and performance of a titanium-based composite coating produced by the HVOF (high-velocity oxygen fuel) spraying method. The feedstock for making the composite coating was produced using high energy mechanical milling of TiO2 and Al powders followed by a combustion reaction. The characteristics of the feedstock powder were improved by treating it with an organic binder. Two types of coatings were produced using treated and untreated feedstock powders. The microstructures and characteristics of both types of coatings were studied, and their thermal shock resistance was accessed by dipping into molten aluminum. The results of this study showed that feedstock treatment did not have a significant effect on the microstructure of the coatings. However, it did affect the uniformity, thickness and surface roughness of the coating on the steel substrate. A coating produced by an untreated feedstock showed better thermal shock resistance in molten aluminum compared with the one produced by PVA (polyvinyl alcohol) treatment.Keywords: coating, feedstock, powder processing, thermal shock resistance, thermally spraying
Procedia PDF Downloads 2729395 Strategic Mine Planning: A SWOT Analysis Applied to KOV Open Pit Mine in the Democratic Republic of Congo
Authors: Patrick May Mukonki
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KOV pit (Kamoto Oliveira Virgule) is located 10 km from Kolwezi town, one of the mineral rich town in the Lualaba province of the Democratic Republic of Congo. The KOV pit is currently operating under the Katanga Mining Limited (KML), a Glencore-Gecamines (a State Owned Company) join venture. Recently, the mine optimization process provided a life of mine of approximately 10 years withnice pushbacks using the Datamine NPV Scheduler software. In previous KOV pit studies, we recently outlined the impact of the accuracy of the geological information on a long-term mine plan for a big copper mine such as KOV pit. The approach taken, discussed three main scenarios and outlined some weaknesses on the geological information side, and now, in this paper that we are going to develop here, we are going to highlight, as an overview, those weaknesses, strengths and opportunities, in a global SWOT analysis. The approach we are taking here is essentially descriptive in terms of steps taken to optimize KOV pit and, at every step, we categorized the challenges we faced to have a better tradeoff between what we called strengths and what we called weaknesses. The same logic is applied in terms of the opportunities and threats. The SWOT analysis conducted in this paper demonstrates that, despite a general poor ore body definition, and very rude ground water conditions, there is room for improvement for such high grade ore body.Keywords: mine planning, mine optimization, mine scheduling, SWOT analysis
Procedia PDF Downloads 2259394 A Comparison of Three Protocols Weight-Loss Interventions for Obese Females
Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia El-Banna, Mohamed S. El Hussieny
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There are several different modalities for treatment of obesity. Common intervention methods for obesity include low-calorie diet, exercise. Also acupuncture has shown good therapeutic results in the treatment of obesity. A recent clinical observation showed that laser acupuncture could reduce body weight and body mass index in obese persons. So, the aim of this research is focused on body composition changes as related to type of intervention, before and after intentional weight loss in overweight and obesity. 76 subjects were included in the study analysis. The present study recommended that every obese female must do lipid profile and fasting blood sugar analysis before weight-loss intervention to take the decision of which method should be used.Keywords: obesity, weight-loss, body composition, modalities
Procedia PDF Downloads 4889393 Attachment Theory and Quality of Life: Grief Education and Training
Authors: Jane E. Hill
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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.Keywords: counselor education and training, grief education and training, grief and loss, quality of life
Procedia PDF Downloads 1919392 The Effect of Sorafenibe on Soat1 Protein by Using Molecular Docking Method
Authors: Mahdiyeh Gholaminezhad
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Context: The study focuses on the potential impact of Sorafenib on SOAT1 protein in liver cancer treatment, addressing the need for more effective therapeutic options. Research aim: To explore the effects of Sorafenib on the activity of SOAT1 protein in liver cancer cells. Methodology: Molecular docking was employed to analyze the interaction between Sorafenib and SOAT1 protein. Findings: The study revealed a significant effect of Sorafenib on the stability and activity of SOAT1 protein, suggesting its potential as a treatment for liver cancer. Theoretical importance: This research highlights the molecular mechanism underlying Sorafenib's anti-cancer properties, contributing to the understanding of its therapeutic effects. Data collection: Data on the molecular structure of Sorafenib and SOAT1 protein were obtained from computational simulations and databases. Analysis procedures: Molecular docking simulations were performed to predict the binding interactions between Sorafenib and SOAT1 protein. Question addressed: How does Sorafenib influence the activity of SOAT1 protein and what are the implications for liver cancer treatment? Conclusion: The study demonstrates the potential of Sorafenib as a targeted therapy for liver cancer by affecting the activity of SOAT1 protein. Reviewers' Comments: The study provides valuable insights into the molecular basis of Sorafenib's action on SOAT1 protein, suggesting its therapeutic potential. To enhance the methodology, the authors could consider validating the docking results with experimental data for further validation.Keywords: liver cancer, sorafenib, SOAT1, molecular docking
Procedia PDF Downloads 279391 Biological Organic or Inorganic Sulfur Sources Feeding Effects on Intake and Some Blood Metabolites of Close-Up Holstein Cows
Authors: Mehdi Kazemi-Bonchenari, Esmaeil Manidari, Vahid Keshavarz
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This study was carried out to investigate the effects of increased level of sulfur by supplementing magnesium sulfate with or without biologically organic source in dairy cow close-up diets on dry matter intake (DMI) and some blood metabolites. The 24 multiparous close-up Holstein cows averaging body weight 687.94 kg and days until expected calving date 21.89 d were allocated in three different treatments (8 cows per each) in a completely randomized design. The first treatment (T1) has contained 0.21% sulfur (DM basis), the second treatment (T2) has contained 0.41% sulfur which entirely supplied through magnesium sulfate and the third treatment (T3) has contained 0.41% sulfur which supplied through combination of magnesium sulfate and an organic source of sulfur. All the cows were fed same diet after parturition until 21 d. The DMI for both pre-calving (P < 0.001) and post-calving was affected by treatments (P < 0.004) and T2 showed the lowest DMI among treatments. Among the blood metabolites, glucose, calcium, and copper were decreased in T2 (P < 0.05). However, blood concentrations of BHBA, NEFA, urea, CPK, and AST were increased in T2 (P < 0.05). The results of the present study indicate that although magnesium sulfate has negative effect on dairy cow health and performance, a combination of magnesium sulfate and biological organic source of sulfur in close-up diets could have positive effects on DMI and performance of Holstein dairy cows.Keywords: organic sulfur, dairy cow, intake, blood metabolites
Procedia PDF Downloads 3099390 A 3-Dimensional Memory-Based Model for Planning Working Postures Reaching Specific Area with Postural Constraints
Authors: Minho Lee, Donghyun Back, Jaemoon Jung, Woojin Park
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The current 3-dimensional (3D) posture prediction models commonly provide only a few optimal postures to achieve a specific objective. The problem with such models is that they are incapable of rapidly providing several optimal posture candidates according to various situations. In order to solve this problem, this paper presents a 3D memory-based posture planning (3D MBPP) model, which is a new digital human model that can analyze the feasible postures in 3D space for reaching tasks that have postural constraints and specific reaching space. The 3D MBPP model can be applied to the types of works that are done with constrained working postures and have specific reaching space. The examples of such works include driving an excavator, driving automobiles, painting buildings, working at an office, pitching/batting, and boxing. For these types of works, a limited amount of space is required to store all of the feasible postures, as the hand reaches boundary can be determined prior to perform the task. This prevents computation time from increasing exponentially, which has been one of the major drawbacks of memory-based posture planning model in 3D space. This paper validates the utility of 3D MBPP model using a practical example of analyzing baseball batting posture. In baseball, batters swing with both feet fixed to the ground. This motion is appropriate for use with the 3D MBPP model since the player must try to hit the ball when the ball is located inside the strike zone (a limited area) in a constrained posture. The results from the analysis showed that the stored and the optimal postures vary depending on the ball’s flying path, the hitting location, the batter’s body size, and the batting objective. These results can be used to establish the optimal postural strategies for achieving the batting objective and performing effective hitting. The 3D MBPP model can also be applied to various domains to determine the optimal postural strategies and improve worker comfort.Keywords: baseball, memory-based, posture prediction, reaching area, 3D digital human models
Procedia PDF Downloads 2169389 Bio-Mimetic Foam Fractionation Technology for the Treatment of Per- and PolyFluoroAlkyl Substances (PFAS) in Contaminated Water
Authors: Hugo Carronnier, Wassim Almouallem, Eric Branquet
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Per- and polyfluoroalkyl Substances (PFAS) are a group of man-made refractory compounds that have been widely used in a variety of industrial and commercial products since the 1940s, leading to contamination of groundwater and surface water systems. They are persistent, bioaccumulative and toxic chemicals. Foam fractionation is a potential remedial technique for treating PFAS-contaminated water, taking advantage of the high surface activity to remove them from the solution by adsorption onto the surface of the air bubbles. Nevertheless, traditional foam fractionation technology developed for PFAS is challenging and found to be ineffective in treating the less surface-active compounds. Different chemicals were the subject of investigation as amendments to achieve better removal. However, most amendments are toxic, expensive and complicated to use. In this situation, patent-pending PFAS technology overcomes these challenges by using rather biological amendments. Results from the first laboratory trial showed remarkable results using a simple and cheap BioFoam Fractionation (BioFF) process based on biomimetics. The study showed that the BioFF process is effective in removing greater than 99% of PFOA (C8), PFOS (C8), PFHpS (C7) and PFHxS (C6) in PFAS-contaminated water. For other PFAS such as PFDA (C10) and 6:2 FTAB, a slightly less stable removal between 94% and 96% was achieved while between 34% and 73% removal efficiency was observed for PFBA (C4), PFBS (C4), PFHxA (C6), and Gen-X. In sum, the advantages of the BioFF presented as a low-waste production, a cost and energy-efficient operation and the use of a biodegradable amendment requiring no separation step after treatment, coupled with these first findings, suggest that the BioFF process is a highly applicable treatment technology for PFAS contaminated water. Additional investigations are currently carried on in order to optimize the process and establish a promising strategy for on-site PFAS remediation.Keywords: PFAS, treatment, foam fractionation, contaminated amendments
Procedia PDF Downloads 789388 Non Pharmacological Approach to IBS (Irritable Bowel Syndrome)
Authors: A. Aceranti, L. Moretti, S. Vernocchi, M. Colorato, P. Caristia
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Irritable bowel syndrome (IBS) is the association between abdominal pain, abdominal distension and intestinal dysfunction for recurring periods. About 10% of the world's population has IBS at any given time in their life, and about 200 people per 100,000 receive an initial diagnosis of IBS each year. Persistent pain is recognized as one of the most pervasive and challenging problems facing the medical community today. Persistent pain is considered more as a complex pathophysiological, diagnostic and therapeutic situation rather than as a persistent symptom. The low efficiency of conventional drug treatments has led many doctors to become interested in the non-drug alternative treatment of IBS, especially for more severe cases. Patients and providers are often dissatisfied with the available drug remedies and often seek complementary and alternative medicine (CAM), a unique and holistic approach to treatment that is not a typical component of conventional medicine. Osteopathic treatment may be of specific interest in patients with IBS. Osteopathy is a complementary health approach that emphasizes the role of the musculoskeletal system in health and promotes optimal function of the body's tissues using a variety of manual techniques to improve body function. Osteopathy has been defined as a patient-centered health discipline based on the principles of interrelation between body structure and function, the body's innate capacity for self-healing and the adoption of a whole person health approach. mainly by practicing manual processing. Studies reported that osteopathic manual treatment (OMT) reduced IBS symptoms, such as abdominal pain, constipation, diarrhea, and improved general well-being. The focus in the treatment of IBS with osteopathy has gone beyond simple spinal alignment, to directly address the abnormal physiology of the body using a series of direct and indirect techniques. The topic of this study was chosen for different reasons: due to the large number of people involved who suffer from this disorder and for the dysfunction itself, since nowadays there is still little clarity about the best type of treatment and, above all, to its origin. The visceral component in the osteopathic field is still a world to be discovered, although it is related to a large part of patient series, it has contents that affect numerous disciplines and this makes it an enigma yet to be solved. The study originated in the didactic practice where the curiosity of a topic is marked that, even today, no one is able to explain and, above all, cure definitively. The main purpose of this study is to try to create a good basis on the osteopathic discipline for subsequent studies that can be exhaustive in the best possible way, resolving some doubts about which treatment modality can be used with more relevance. The path was decided to structure it in such a way that 3 types of osteopathic treatment are used on 3 groups of people who will be selected after completing a questionnaire, which will deem them suitable for the study. They will, in fact, be divided into three groups where: - the first group was given a visceral osteopathic treatment. - The second group was given a manual osteopathic treatment of neurological stimulation. - The third group received a placebo treatment. At the end of the treatment, questionnaires will be re-proposed respectively one week after the session and one month after the treatment from which any data will be collected that will demonstrate the effectiveness or otherwise of the treatment received. The sample of 50 patients examined underwent an oral interview to evaluate the inclusion and exclusion criteria to participate in the study. Of the 50 patients questioned, 17 people who underwent different osteopathic techniques were eligible for the study. Comparing the data related to the first assessment of tenderness and frequency of symptoms with the data related to the first follow-up shows a significant improvement in the score assigned to the different questions, especially in the neurogenic and visceral groups. We are aware of the fact that it is a study performed on a small sample of patients, and this is a penalizing factor. We remain, however, convinced that having obtained good results in terms of subjective improvement in the quality of life of the subjects, it would be very interesting to re-propose the study on a larger sample and fill the gaps.Keywords: IBS, osteopathy, colon, intestinal inflammation
Procedia PDF Downloads 1019387 Hematological Changes in Oral Cancer Patients with Smokable and Chewable Tobacco
Authors: Mohsin Ali Baloch, Saira Baloch
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Objective: To analyze hematological changes in patients of oral cancer with history of smokable and chewable tobacco use, and to compare them with healthy controls. Study Design: Descriptive type of study survey. Setting: This study was conducted at the Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro. Study Period: One year July, 2013 to July, 2014. Subject and Methods: Histopathologically confirmed hundred cases of oral cancer with the history of smokable and non-smokable tobacco were selected to analyze the hematological variation. Inclusion Criteria: Histopathologically diagnosed patients of oral squamous cell carcinoma, with history of smokable and non-smokable tobacco. Exclusion Criteria: Patient with any systemic medically compromising problem, terminally ill patients, radio or chemotherapeutically treated patients, patients with metastasis to lungs or any distant metastasis, patients with the history of more than one well-defined etiological factor involved. Results: There were 73% patients of oral cancer reported with anemic. Significantly lower values of Hb, platelet, and higher mean values of ESR, TLC, and were observed in both groups of oral cancer patients; tobacco smokers and tobacco chewers as compared to non-smokers healthy controls. There was more decline in the level of haemoglobin and incline in the level of ESR observed in tobacco chewer oral cancer patients as compared to tobacco smokers patients, while TLC was more observed in smokers. Conclusion: Oral cancer patients with a history of chewable/smokable tobacco have likely worse hematological profile, which increases the anesthetic and surgical challenges for maxillofacial surgeons, which have a significant impact on treatment planning as well.Keywords: oral cancer, hematological variations, tobacco, smokers
Procedia PDF Downloads 4369386 Thermo-Mechanical Treatment of Chromium Alloyed Low Carbon Steel
Authors: L. Kučerová, M. Bystrianský, V. Kotěšovec
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Thermo-mechanical processing with various processing parameters was applied to 0.2%C-0.6%Mn-2S%i-0.8%Cr low alloyed high strength steel. The aim of the processing was to achieve the microstructures typical for transformation induced plasticity (TRIP) steels. Thermo-mechanical processing used in this work incorporated two or three deformation steps. The deformations were in all the cases carried out during the cooling from soaking temperatures to various bainite hold temperatures. In this way, 4-10% of retained austenite were retained in the final microstructures, consisting further of ferrite, bainite, martensite and pearlite. The complex character of TRIP steel microstructure is responsible for its good strength and ductility. The strengths achieved in this work were in the range of 740 MPa – 836 MPa with ductility A5mm of 31-41%.Keywords: pearlite, retained austenite, thermo-mechanical treatment, TRIP steel
Procedia PDF Downloads 2939385 Nimart-trained Nurses' Perspectives Regarding Virally Unsuppressed Children HIV-positive on Antiretroviral Therapy and Missing Scheduled Clinic Visits: Mopani District, Limpopo Province
Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba
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Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments
Procedia PDF Downloads 1049384 Thyroid Cancer Treatment in Yemen Under Blockade Conditions and Absence of Radioactive Iodine
Authors: Anis Al-Yakhiri
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Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results
Procedia PDF Downloads 829383 The Basics of Cognitive Behavioral Family Therapy and the Treatment of Various Physical and Mental Diseases
Authors: Mahta Mohamadkashi
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The family is the most important source of security and health for the people of the society, and at the same time, it is the main field of creating all kinds of social and psychological problems. On the one hand, a family is a natural group with many goals and roles that are important and necessary for all family members. On the other hand, the family is a strong and organized group that recruits the therapist because of the goals that are concealed in its policy and procedures. The relationship between the environment and the family background with mental illnesses has been the focus of various researchers for a long time, and the research and experiments that have been conducted to show that the functioning of the family is related to the mental health of the members of the family. Currently, several theoretical perspectives with different approaches seek to explain and resolve psychological problems and family conflicts that can be mentioned. This research aims to investigate "cognitive-behavioral family therapy" by using the "family therapy" research method which is included the descriptive-analytical method and the method of collecting library information, with special reliance on Persian and Latin books and articles. for considering one of the important approaches of family therapy that we are going which have been known as data and its conditions that also includes requirements and limitations. For this purpose, in the beginning, brief background and introduction about family and family therapy are going to describe, and then the basics of cognitive-behavioral family therapy and the implementation process and various techniques of this approach can go through a big discussion. After that, we will apply this approach in the treatment of various physical and mental diseases in the form of related research, and we will examine the ups and downs of the implementation procedures, limitations, and future directions in this field. In general, This study emphasizes the role of the family system in the occurrence of psychological diseases and disorders and also validates the role of the family system in the treatment of those diseases and disorders. Also, cognitive-behavioral family therapy has been approved as an effective treatment approach for a variety of mental disorders.Keywords: cognitive-behavioral, family, family therapy, cognitive-behavioral family therapy
Procedia PDF Downloads 1019382 Identification of the Microalgae Species in a Wild Mix Culture Acclimated to Landfill Leachate and Ammonia Removal Performances in a Microbubble Assisted Photobioreactor
Authors: Neslihan Ozman Say, Jim Gilmour, Pratik Desai, William Zimmerman
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Landfill leachate treatment has been attracting researchers recently for various environmental and economical reasons. Leachate discharge to receiving waterbodies without treatment causes serious detrimental effects including partial oxygen depletion due to high biological oxygen demand (BOD) and chemical oxygen demand (COD) concentrations besides toxicity of heavy metals it contains and high ammonia concentrations. In this study, it is aimed to show microalgal ammonia removal performances of a wild microalgae consortia as an alternative treatment method and determine the dominant leachate tolerant species for this consortia. For the microalgae species identification experiments a microalgal consortium which has been isolated from a local pond in Sheffield inoculated in %5 diluted raw landfill leachate and acclimated to the leachate by batch feeding for a month. In order to determine the most tolerant microalgal consortium, four different untreated landfill leachate samples have been used as diluted in four different ratios as 5%, 10%, 20%, and 40%. Microalgae cell samples have been collected from all experiment sets and have been examined by using 18S rDNA sequencing and specialised gel electrophoresis which are adapted molecular biodiversity methods. The best leachate tolerant algal consortium is being used in order to determine ammonia removal performances of the culture in a microbubble assisted photobioreactor (PBR). A porous microbubble diffuser which is supported by a fluidic oscillator is being used for dosing CO₂ and air mixture in the PBR. It is known that high mass transfer performance of microbubble technology provides a better removal efficiency and a better mixing in the photobioreactor. Ammonia concentrations and microalgal growth are being monitored for PBR currently. It is aimed to present all the results of the study in final paper submission.Keywords: ammonia removal from leachate, landfill leachate treatment, microalgae species identification, microbubble assisted photobioreactors
Procedia PDF Downloads 1609381 Characterization and Evaluation of Soil Resources for Sustainable Land Use Planning of Timatjatji Community Farm, Limpopo, South Africa
Authors: M. Linda Phooko, Phesheya E. Dlamini, Vusumuzi E. Mbanjwa, Rhandu Chauke
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The decline of yields as a consequence of miss-informed land-use decisions poses a threat to sustainable agriculture in South Africa. The non-uniform growth pattern of wheat crop and the yields below expectations has been one of the main concerns for Timatjatji community farmers. This study was then conducted to characterize, classify, and evaluate soils of the farm for sustainable land use planning. A detailed free survey guided by surface features was conducted on a 25 ha farm to check soil variation. It was revealed that Sepane (25%), Bonheim (21%), Rensburg (18%), Katspruit (15%), Arcadia (12%) and Dundee (9%) were the dominant soil forms found across the farm. Field soil description was done to determine morphological characteristics of the soils which were matched with slope percentage and climate to assess the potential of the soils. The land capability results showed that soils were generally shallow due to high clay content in the B horizon. When the climate of the area was factored in (i.e. land potential), it further revealed that the area has low cropping potential due to heat, moisture stress and shallow soils. This implies that the farm is not suitable for annual cropping but can be highly suitable for planted pastures.Keywords: characterization, land capability, land evaluation, land potential
Procedia PDF Downloads 1999380 Sustainability and Clustering: A Bibliometric Assessment
Authors: Fernanda M. Assef, Maria Teresinha A. Steiner, David Gabriel F. Barros
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Review researches are useful in terms of analysis of research problems. Between the types of review documents, we commonly find bibliometric studies. This type of application often helps the global visualization of a research problem and helps academics worldwide to understand the context of a research area better. In this document, a bibliometric view surrounding clustering techniques and sustainability problems is presented. The authors aimed at which issues mostly use clustering techniques, and, even which sustainability issue would be more impactful on today’s moment of research. During the bibliometric analysis, we found ten different groups of research in clustering applications for sustainability issues: Energy; Environmental; Non-urban planning; Sustainable Development; Sustainable Supply Chain; Transport; Urban Planning; Water; Waste Disposal; and, Others. And, by analyzing the citations of each group, we discovered that the Environmental group could be classified as the most impactful research cluster in the area mentioned. Now, after the content analysis of each paper classified in the environmental group, we found that the k-means technique is preferred for solving sustainability problems with clustering methods since it appeared the most amongst the documents. The authors finally conclude that a bibliometric assessment could help indicate a gap of researches on waste disposal – which was the group with the least amount of publications – and the most impactful research on environmental problems.Keywords: bibliometric assessment, clustering, sustainability, territorial partitioning
Procedia PDF Downloads 1099379 Efficacy of Hemi-Facetectomy in Treatment of Lumbar Foraminal Stenosis
Authors: Manoj Deepak, N. Mathivanan, K. Venkatachalam
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Nerve root stenosis is one of the main cause for back pain. There are many methods both conservative and surgical to treat this disease. It is pertinent to decompress the spine to a proper extent so as to avoid the recurrence of symptoms. But too much of an aggressive approach also has its disadvantages. We present one of the methods to effectively decompress the nerve with better results. Our study was carried out in 52 patients with foramina stenosis between 2008 to 2011.We carried out the surgical procedure of shaving off the medial part of the facet joint so as to decompress the root. We selected those patients who had symptoms of claudication for more than 2 years. They had no signs of instability and they underwent conservative treatment for a period of 2 months before the procedure. Oswersty scoring was used to record the functional level of the patient before and after the procedure. All patients were followed up for a period of minimum 2.5 years. After evaluation for a minimum of 2.5 years, 34 patients had no evidence of recurrence of symptoms with improvement in the functional level.7 patients complained of minimal pain but their functional quality had improved postop. Six patients had symptoms of lumbar canal disease which reduced with conservative treatment. 5 patients required spinal fusion surgeries in the later period. Conclusion: Thus, we can effectively conclude that our procedure is safe and effective in reducing the symptoms in those patients with neurogenic claudication.Keywords: facetectoemy, stenosis, decompression, Lumbar Foraminal Stenosis, hemi-facetectomy
Procedia PDF Downloads 3509378 Multilevel Modelling of Modern Contraceptive Use in Nigeria: Analysis of the 2013 NDHS
Authors: Akiode Ayobami, Akiode Akinsewa, Odeku Mojisola, Salako Busola, Odutolu Omobola, Nuhu Khadija
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Purpose: Evidence exists that family planning use can contribute to reduction in infant and maternal mortality in any country. Despite these benefits, contraceptive use in Nigeria still remains very low, only 10% among married women. Understanding factors that predict contraceptive use is very important in order to improve the situation. In this paper, we analysed data from the 2013 Nigerian Demographic and Health Survey (NDHS) to better understand predictors of contraceptive use in Nigeria. The use of logistics regression and other traditional models in this type of situation is not appropriate as they do not account for social structure influence brought about by the hierarchical nature of the data on response variable. We therefore used multilevel modelling to explore the determinants of contraceptive use in order to account for the significant variation in modern contraceptive use by socio-demographic, and other proximate variables across the different Nigerian states. Method: This data has a two-level hierarchical structure. We considered the data of 26, 403 married women of reproductive age at level 1 and nested them within the 36 states and the Federal Capital Territory, Abuja at level 2. We modelled use of modern contraceptive against demographic variables, being told about FP at health facility, heard of FP on TV, Magazine or radio, husband desire for more children nested within the state. Results: Our results showed that the independent variables in the model were significant predictors of modern contraceptive use. The estimated variance component for the null model, random intercept, and random slope models were significant (p=0.00), indicating that the variation in contraceptive use across the Nigerian states is significant, and needs to be accounted for in order to accurately determine the predictors of contraceptive use, hence the data is best fitted by the multilevel model. Only being told about family planning at the health facility and religion have a significant random effect, implying that their predictability of contraceptive use varies across the states. Conclusion and Recommendation: Results showed that providing FP information at the health facility and religion needs to be considered when programming to improve contraceptive use at the state levels.Keywords: multilevel modelling, family planning, predictors, Nigeria
Procedia PDF Downloads 4199377 Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients with Diabetes Mellitus
Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte
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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus
Procedia PDF Downloads 699376 Sustainable Drinking Water Treatment Method Using Solar Light
Authors: Ayushi Arora
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Solar photocatalysis has the potential to treat drinking water in a sustainable and cost effective manner. According to WHO, there should not be any colony forming units (CFU) per 100 mL present in drinking water, and as per the Central Pollution Control Board (CPCB) of India, the bathing water should have less than 500 CFU/100 mL and the maximum permissible limit is 2500 CFU/100 mL. In this study, 8 water sources near our collaborators, Indian Institute of Technology, Kharagpur, India, were analysed, and it was found that 6 out of 8 sources of water had significant coliform count in them. Two of them were chosen to be treated by solar photocatalysis a) well water which had a count of 4800 CFU/100 mL for total coliforms and was used by people for drinking purposes, and b) pond water which had a count of 92000 CFU/100 mL for total coliforms and 3000 CFU/mL for E.Coli and was used by people for washing and bathing purposes. In this study, a semiconductor-semiconductor, composite BTO-TiO2-RMSG & TiO2-SiO2 were tested for their ability to be activated under solar light and to reduce Total Coliforms and E.Coli bacteria in real world contaminated water, and it was found that both catalysts were both able to reduce the total coliform count in water by 99.7% and 98.2 % in 2 hrs respectively. They have also shown promising results in reusability tests. This study demonstrates the ability of solar photocatalysis to be used in real world drinking water treatment and will promote future advancements in this field.Keywords: sustainable water treatment, waterpurification technologies, water policies, water pollution and environmental engineering
Procedia PDF Downloads 819375 Managing Subretinal Bleeds with Intravitreal Aflibercept
Authors: Prachi Abhishek Dave, Abhishek Dave
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Purpose: The purpose of this study is to elucidate the role of intravitreal injection Aflibercept in managing complex cases of Wet Age Related Macular Degeneration (ARMD) and the gratifying visual recovery experienced with a minimally invasive procedure. Methods: A 73-year-old gentleman presented with a drop in vision in the left eye for 25 days. On examination, his best corrected visual acuity (BCVA) in the Right eye (OD) was 6/60, and finger counting close to face in the Left eye (OS). On multimodal imaging, he was diagnosed to have a scarred Wet ARMD in OD and an active Wet ARMD with a large subretinal bleed secondary to Wet ARMD in OS. Treatment management options included monotherapy with an Injection Aflibercept or an intravitreal gas injection with tPA followed by Injection Aflibercept. Considering his one-eyed status, the patient decided to go for Aflibercept monotherapy. Results: After 3 monthly injections of injection Aflibercept, the subretinal bleed reduced, the subretinal fluid resolved, and his vision in OS improved to 6/9. He is on a regular follow-up and has not needed any further injections in OS and he maintains 6/9 vision. Conclusions: Conventional treatment guidelines for a large subretinal bleed dictate the use of gas followed by intravitreal Injection Aflibercept. However, gas has its own limitations of causing a rise in intraocular pressure and a transient loss of vision, which is particularly troublesome in one-eyed patients. Injection Aflibercept offers a much safer, less invasive, and elegant treatment option for such patients with equally good or even better visual outcomes.Keywords: wet ARMD, subretinal bleed, intravitreal injections, aflibercept, EYELEA, intravitreal gas
Procedia PDF Downloads 429374 Recommendations Using Online Water Quality Sensors for Chlorinated Drinking Water Monitoring at Drinking Water Distribution Systems Exposed to Glyphosate
Authors: Angela Maria Fasnacht
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Detection of anomalies due to contaminants’ presence, also known as early detection systems in water treatment plants, has become a critical point that deserves an in-depth study for their improvement and adaptation to current requirements. The design of these systems requires a detailed analysis and processing of the data in real-time, so it is necessary to apply various statistical methods appropriate to the data generated, such as Spearman’s Correlation, Factor Analysis, Cross-Correlation, and k-fold Cross-validation. Statistical analysis and methods allow the evaluation of large data sets to model the behavior of variables; in this sense, statistical treatment or analysis could be considered a vital step to be able to develop advanced models focused on machine learning that allows optimized data management in real-time, applied to early detection systems in water treatment processes. These techniques facilitate the development of new technologies used in advanced sensors. In this work, these methods were applied to identify the possible correlations between the measured parameters and the presence of the glyphosate contaminant in the single-pass system. The interaction between the initial concentration of glyphosate and the location of the sensors on the reading of the reported parameters was studied.Keywords: glyphosate, emergent contaminants, machine learning, probes, sensors, predictive
Procedia PDF Downloads 1239373 School Emergency Drills Evaluation through E-PreS Monitoring System
Authors: A. Kourou, A. Ioakeimidou, V. Avramea
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Planning for natural disasters and emergencies is something every school or educational institution must consider, regardless of its size or location. Preparedness is the key to save lives if a disaster strikes. School disaster management mirrors individual and family disaster prevention, and wider community disaster prevention efforts. This paper presents the usage of E-PreS System as a helpful, managerial tool during the school earthquake drill, in order to support schools in developing effective disaster and emergency plans specific to their local needs. The project comes up with a holistic methodology using real-time evaluation involving different categories of actors, districts, steps and metrics. The main outcomes of E-PreS project are the development of E-PreS web platform that host the needed data of school emergency planning; the development of E-PreS System; the implementation of disaster drills using E-PreS System in educational premises and local schools; and the evaluation of E-PreS System. Taking into consideration that every disaster drill aims to test and valid school plan and procedures; clarify and train personnel in roles and responsibilities; improve interagency coordination; identify gaps in resources; improve individual performance; and identify opportunities for improvement, E-PreS Project was submitted and approved by the European Commission (EC).Keywords: disaster drills, earthquake preparedness, E-PreS System, school emergency plans
Procedia PDF Downloads 2289372 The Association Between CYP2C19 Gene Distribution and Medical Cannabis Treatment
Authors: Vichayada Laohapiboolkul
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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer
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